NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 25, 2024
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a permanent discontinuance of copayments for all Medicaid beneficiaries.
Effective May 1, 2024, Nebraska Medicaid will update the Medicaid State Plan to no longer assess copayments for selected services.
The estimated increase in annual aggregate expenditures is:
FFY24: $10,568 ($8,405 Federal funds / $2,163 General funds)
FFY25: $25,364 ($20,081 Federal funds / $5,283 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 14, 2024
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement an extension to temporary disaster relief policies.
Effective May 1, 2024, this amendment extends temporary disaster relief policies previously implemented through emergency state plan amendments. These provisions include suspending premiums for individuals in the Transitional Medical Assistance program. This extended disaster relief policy will remain in effect through September 30, 2024.
The estimated increase in annual aggregate expenditures is:
FFY24: $316,789 ($185,639 Federal funds / $131,151 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 14, 2024
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement cost-sharing provisions for certain Medicaid beneficiaries enrolled in the Medicaid Insurance for Workers with Disabilities (MIWD) program.
Effective May 1, 2024, Medicaid beneficiaries enrolled in the MIWD program with income 200% or more but less than 250 percent of the Federal Poverty Level will have a monthly premium applied which must be paid in order to receive coverage. The premium schedule will be updated to reflect the updated Federal Poverty Level amounts. Nebraska's State Plan Amendment will be updated to reflect the change in the premium cap to 7.5 percent.
The estimated change in annual aggregate expenditures is:
FFY24: $0 ($0 Federal funds /$0 General funds)
FFY25: $0 ($0 Federal funds / $0 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 30, 2023
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and serves to open the 14-day public comment period. All comments must be received by December 14, 2023.
The Nebraska Department of Health and Human Services will be integrating dental services into the managed care programs and discontinuing dental benefits provided through the dental benefits manager, MCNA Dental Insurance Company. The managed care programs will continue to be responsible for administering services to all eligible managed care recipients. The Department continues to provide services to recipients through the managed care model.
Effective January 1, 2024.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2024.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on October 12, 2023. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services.
All comments must be received by December 14, 2023.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 29, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will submit a state plan amendment to add a Therapeutic Family Care (TFC) program. The TFC program serves Medicaid-eligible children up to age 19 who are at the intensive plus or specialized level of foster care and meet additional needs-based criteria. This program includes crisis service maintenance and stabilization and mobile crisis services. Eligibility for the TFC program will be phased in to include Medicaid-eligible children and youth up to age 19 who are at the Intensive level of foster care and probation-involved youth.
Effective April 1, 2024, the TFC program includes crisis services and mobile crisis services.
The estimated increase in annual aggregate expenditures is:
FFY24: $1,620,810 ($949,795 / $671,015)
FFY25: $3,274,036 ($1,883,226 / $1,390,811)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: October 13, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a state plan amendment to eliminate the $750-per-year adult dental benefit limit, to allow public health licensed dental hygienists to provide certain dental services, and to better align language in the State Plan with state regulations in 471 NAC 6.
The effective date is January 1, 2024.
The estimated increase in annual aggregate expenditures is:
FFY24: $1,203,750 (Federal funds $705,398 / General funds $498,352)
FFY25: $1,621,050 (Federal funds $947,342 / General funds $673,708)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: October 13, 2023
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by November 12, 2023.
The Nebraska Department of Health and Human Services will submit a SPA to eliminate the $750-per-year adult dental benefit limit, to allow public health licensed dental hygienists to provide certain dental services, and to better align language in the State Plan with state regulations in 471 NAC 6.
Effective January 1, 2024.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2024.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on October 12, 2023. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by November 12, 2023.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: September 6, 2023
In accordance with 42 CFR 438.340, the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice that the updated Heritage Health Quality Strategy is available for public review and comment. A copy of this document has been shared with Nebraska Tribal Representatives in accordance with the state's Tribal consultation policy, and will be discussed during the next Tribal consultation meeting on September 6th.
MLTC reviews and updates the Heritage Health Quality Strategy every three years, and in this review cycle there have been significant changes which require the opportunity for public review and comment. The draft Quality Strategy can be viewed here: https://dhhs.ne.gov/Documents/2023%20Quality%20Strategy_Draft%20for%20Public%20Comment.pdf.
Please provide all comments to MLTC by September 24th, 2023.
Comments may be submitted to:
Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care
301 Centennial Mall S
PO Box # 95026
Attn: Catherine Kearney
Lincoln, Nebraska 68509-5026
Email to DHHS.HeritageHealth@nebraska.gov, Attn: Catherine Kearney
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: July 26, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement reimbursement to a hospital for Medicaid beneficiaries admitted to an inpatient hospital who no longer meet acute inpatient level of care and discharge planning, but still require facility level of care and are unable to be transferred to a nursing facility.
The effective date is September 2, 2023.
The estimated increase in annual aggregate expenditures is:
FFY24: $77,033 ($45,141 / $31,892)
FFY25: $77,996 ($45,581 / $32,415)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 1, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a state plan amendment to allow Rural Health Clinics in Nebraska to bill and be reimbursed at their encounter rate for qualifying services provided via telehealth.
The effective date of this proposed amendment is July 1, 2023.
The estimated increase in annual aggregate expenditures is:
FFY2023: $0 ($0 Federal funds / $0 General funds)
FFY2024: $0 ($0 Federal funds / $0 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 31, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement Medicaid provider rate increases for outpatient and professional services for state fiscal year 2024. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB814 (2023). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2023.
The estimated increase in annual aggregate expenditures is:
FFY23: $699,351 ($422,198 Federal funds / $277,153 General funds)
FFY24: $2,774,601 ($1,636,321 Federal funds / $1,138,280 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 31, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement Medicaid provider rate increases for inpatient services for state fiscal year 2024. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB814 (2023). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2023.
The estimated increase in annual aggregate expenditures is:
FFY23: $45,505 ($27,471 Federal funds / $18,034 General funds)
FFY24: $180,537 ($106,472 Federal funds / $74,065 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 31, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice regarding nursing facility (NF) rates for state fiscal year 2024. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB814 (2023), rebasing of rates based on state fiscal year 2022 audited cost reports, and the transition to a new nursing case mix system. Additionally, The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice regarding intermediate care facility for individuals with developmental disabilities (ICF-DD) rates for state fiscal year 2024. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB814 (2023).
The updated Medicaid payment rates for both NF and ICF-DD are effective for services on or after July 1, 2023.
Nursing Facilities: For the rate period of July 1, 2023 through June 30, 2024, the inflation factor is positive 3.5%.
ICF-DD Facilities: For the rate period of July 1, 2023 through June 30, 2024, the inflation factor is positive 24.0%.
The estimated increase in annual aggregate expenditures for nursing facility and intermediate care facility rates is:
FFY2023: $3,677,277 ($2,219,972 Federal funds / $1,457,305 General funds)
FFY2024: $14,589,197 ($8,603,979 Federal funds / $5,985,218 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 2, 2023
In accordance with 42 CFR 431.408, the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of the Nebraska Section 1115 Substance Use Disorder (SUD) Demonstration Waiver Renewal application. The 1115 SUD demonstration waiver, effective July 1, 2019, provides DHHS with the authority to receive federal Medicaid financial participation (FFP) for the coverage of SUD treatment-related stays in Institutions for Mental Diseases (IMDs) for adults ages 21-64. More specifically, the authority allows the state the flexibility to include in managed care capitation rate development IMD stays that exceed the 15-day limit found in 42 CFR 438.6(e). DHHS is requesting renewal of the waiver for an additional five (5) year period, July 1, 2024, through June 30, 2029.
The public hearings will be held Friday, May 12th, at 11 AM - 12 PM CST and Thursday, May 18th, at 12:30 PM - 1:30 PM CST in the Goldenrod Room, located in the lower level of the Nebraska State Office Building (301 Centennial Mall S, Lincoln, NE 68509).
| Public Hearing Date | Time | Webinar | Webinar Password |
| Friday May 12, 2023 | 11:00 AM – 12:00 PM Central Standard Time | Link to the Webinar | asEJpC9MG23 |
| Thursday May 18, 2023 | 12:30PM – 1:30 PM
Central Standard Time
| Link to the Webinar | AEazmJ42NJ4 |
DHHS is allowing 30 calendar days for public review and comment on the demonstration amendment. Please respond no later than June 1, 2023.
Comments may be submitted to:
Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care
301 Centennial Mall S
PO Box # 95026
Attn. Milla Jones
Lincoln, Nebraska 68509-5026
Fax (402) 471-9103 or e-mail to DHHS.DemonstrationWaivers@nebraska.gov
For more information on the Section 1115 SUD Demonstration Waiver or to view the renewal application for feedback, visit the Substance Use Disorder Demonstration Program website.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: April 12, 2023
In accordance with 42 CFR 431.408, the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of two (2) public hearings for the public to ask questions and provide feedback on the Nebraska Section 1115 Substance Use Disorder (SUD) Demonstration Waiver Renewal application. The 1115 SUD demonstration waiver, effective July 1, 2019, provides Nebraska DHHS with the authority to receive federal Medicaid financial participation (FFP) for the coverage of SUD treatment-related stays in Institutions for Mental Diseases (IMDs) for adults ages 21-64. More specifically, the authority allows the state the flexibility to include in managed care capitation rate development IMD stays that exceed the 15-day limit found in 42 CFR 438.6(e). DHHS is requesting renewal for another five (5) year period, July 1, 2024, through June 30, 2029, without changes to the waiver.
The public hearings will be held Friday, May 12th, at 11 AM - 12 PM CST and Thursday, May 18th, at 12:30 PM - 1:30 PM CST in the Lower-level Public Hearing Room located at the Nebraska State Office Building (301 Centennial Mall S, Lincoln, NE 68509).
Webex Invite Links:
Friday, May 12th, at 11 AM - 12 PM CST
WebEx invite link: https://sonvideo.webex.com/sonvideo/j.php?MTID=m2db7654930f8a5e1bc6c0bf4d2c31fc9
Password: asEJpC9MG23
Thursday, May 18th, at 12:30 PM - 1:30 PM CST
WebEx invite link: https://sonvideo.webex.com/sonvideo/j.php?MTID=mc6fdc585ef52f3ce3f862bf2704d6f76
Password: AEazmJ42NJ4
Please email the Demonstration Waivers Team at DHHS.DemonstrationWaivers@nebraska.gov with any questions prior to the public hearing. For more information on the Section 1115 SUD Demonstration Waiver, visit the Substance Use Disorder Demonstration Program website.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 29, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement an extension to temporary disaster relief policies.
Effective May 12, 2023, this amendment extends temporary disaster relief policies previously implemented through emergency state plan amendments. These provisions include suspending copayments and premiums and allowing for reasonable opportunity extensions to satisfactorily verify non-citizen status. These extended temporary disaster relief policies will remain in effect through April 30, 2024.
The estimated increase in annual aggregate expenditures is:
FFY23: $334,872 ($193,790 Federal funds / $141,082 General funds)
FFY24: $443,505 ($259,894 Federal funds / $183,611 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 29, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a provider rate increase effective for basic personal assistance services on or after January 1, 2023. The increase in the hourly equivalent of the service rate will be commensurate with increases in the Nebraska minimum wage.
The payment rates are effective for services on or after January 1, 2023.
The estimated increase in annual aggregate expenditures is:
FFY23: $599,523 ($346,944 Federal funds / $252,579 General funds)
FFY24: $1,757,066 ($1,029,641 Federal funds / $727,425 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 1, 2022
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by December 31, 2022. The Nebraska Department of Health and Human Services will submit a SPA to allow a nurse practitioner, physician assistant, clinical nurse specialist, or certified nurse midwife to order home health services and to certify plan of care in the Nebraska Alternative Benefit Plan (ABP).
Effective January 1, 2023.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2023.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on December 1, 2022. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by December 31, 2022.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 10, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will submit a state plan amendment (SPA) to make a technical change identified by the Centers for Medicare and Medicaid Services noting that physician-administered drugs are paid at the Medicare drug fee schedule rate rather than the average sales price + 6% if the drug is listed on the Medicare drug fee schedule.
The effective date is November 11, 2022.
The estimated increase in annual aggregate expenditures is:
FFY23: $427 ($260 Federal / $167 General)
FFY24: $436 ($255 Federal / $181 General)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 4, 2022
In accordance with 42 CFR 431.420(c), the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of a public forum for the public to learn about the current implementation status of the state's Section 1115 Substance Use Disorder (SUD) Demonstration Waiver for SUD services. The 1115 SUD demonstration waiver, effective July 1, 2019, provides Nebraska DHHS with the authority to receive federal Medicaid financial participation (FFP) for the coverage of SUD treatment-related stays in Institutions for Mental Diseases (IMDs) for adults ages 21-64. More specifically, the authority allows the state the flexibility to include in managed care capitation rate development IMD stays that exceed the 15-day limit found in 42 CFR 438.6(e).
The public forum will be held Wednesday, December 14, at 2-3 PM CST. Please email the Demonstration Waivers Team at DHHS.DemonstrationWaivers@nebraska.gov with any questions prior to the public forum.
WebEx invite link: https://sonvideo.webex.com/sonvideo/j.php?MTID=mdebdd782f63b53aba0e16e85584f419d
Password: EEd4DMd5St3
For more information on the Section 1115 SUD Demonstration Waiver visit the Substance Use Disorder Demonstration Program website.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: September 21, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a state plan amendment to allow Indian health care providers in Nebraska to bill and be reimbursed at the Indian Health Services encounter rate for qualifying services provided via telehealth.
The effective date of this proposed amendment is October 1, 2022.
The estimated increase in annual aggregate expenditures is:
FFY2023: $0 ($0 Federal funds / $0 General funds)
FFY2024: $0 ($0 Federal funds / $0 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 29, 2023
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement an extension to temporary disaster relief policies.
Effective May 12, 2023, this amendment extends temporary disaster relief policies previously implemented through emergency state plan amendments. These provisions include suspending copayments and premiums and allowing for reasonable opportunity extensions to satisfactorily verify non-citizen status. These extended temporary disaster relief policies will remain in effect through April 30, 2024.
The estimated increase in annual aggregate expenditures is:
FFY23: $334,872 ($193,790 Federal funds / $141,082 General funds)
FFY24: $443,505 ($259,894 Federal funds / $183,611 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: September 21, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice that it will submit a state plan amendment to fully implement the requirements of the American Rescue Plan.
Effective March 11, 2021, this amendment makes permanent changes that were previously implemented through emergency state plan amendments. These changes include requirements of the American Rescue Plan to provide COVID-19 vaccines, testing, and treatment.
The estimated increase in annual aggregate expenditures is:
FFY23: $45,940 ($45,940 Federal / $0 State)
FFY24: $21,748 ($19,461 Federal / $2,287 State)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: August 31, 2022
Updated: September 2, 2022
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by September 30, 2022.
The Nebraska Department of Health and Human Services will submit a SPA to allow a nurse practitioner, clinical nurse specialist, and nurse midwife to order home health services and to certify plan of care in the Nebraska Alternative Benefit Plan (ABP).
Effective October 1, 2022.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than December 31, 2022.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on August 25, 2022. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by September 30, 2022.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 23, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice of a payment rate change for some Medicaid covered services available to eligible clients in Nebraska. Medicaid will implement a 2.00% increase in provider rates for non-behavioral health outpatient services and a 17.00% increase in provider rates for behavioral health outpatient services. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021) and LB1011 (2022). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2022.
The estimated increase in annual aggregate expenditures for outpatient rates is:
FFY2022: $25,466 ($14,719 Federal funds / $10,747 General funds)
FFY2023: $101,864 ($58,949 Federal funds / $42,915 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 23, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice of a payment rate change for some Medicaid covered services available to eligible clients in Nebraska. Medicaid will implement a 2.00% increase in provider rates for non-behavioral health inpatient services and a 17.00% increase in provider rates for behavioral health inpatient services. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021) and LB1011 (2022). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2022.
The estimated increase in annual aggregate expenditures for inpatient rates is:
FFY2022: $32,322 ($18,682 Federal funds / $13,640 General funds)
FFY2023: $129,289 ($74,820 Federal funds / $54,469 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 23, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice regarding intermediate care facility for individuals with developmental disabilities (ICF-DD) rates for state fiscal year 2023. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021).
The updated Medicaid payment rates are effective for services on or after July 1, 2022.
For the rate period of July 1, 2022 through June 30, 2023, the inflation factor for ICF-DD is positive 18.60%.
The estimated increase in annual aggregate expenditures for ICF-DD rates is:
FFY2022: $601,555 ($347,699 Federal funds / $253,856 General funds)
FFY2023: $1,804,666 ($1,044,360 Federal funds / $760,306 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 23, 2022
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice regarding nursing facility rates for state fiscal year 2023. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB1011 (2022).
The updated Medicaid payment rates are effective for services on or after July 1, 2022.
Nursing Facilities: For the rate period of July 1, 2022 through June 30, 2023, the inflation factor is positive 35.74%.
The estimated increase in annual aggregate expenditures for nursing facility rates is:
FFY2022: $18,297,450 ($10,575,926 Federal funds / $7,721,524 General funds)
FFY2023: $54,892,350 ($31,766,203 Federal funds / $23,126,147 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 12, 2022
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for the Expanded Adult Population
Nebraska Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by June 11, 2022.
The Nebraska Department of Health and Human Services will submit a SPA to add coverage of routine patient costs for services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials to the Nebraska Alternative Benefit Plan (ABP).
Effective January 1, 2022.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the SPA to the Centers for Medicare and Medicaid Services no later than June 15, 2022.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on February 23, 2022. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by June 11, 2022.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 29, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice that it intends to submit a State Plan Amendment for the new mandatory benefit for coverage of routine patient costs for services furnished in connection with participation by Medicaid beneficiaries in qualifying clinical trials. To the extent that negotiations with the Centers for Medicare & Medicaid Services (CMS) or additional guidance from CMS on this new mandatory coverage results in changes, the state will update this notice accordingly.
Effective January 1, 2022
There is no estimated change in annual aggregate expenditures.
FFY22: $0 ($0 Federal funds / $0 General funds)
FFY23: $0 ($0 Federal funds / $0 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 28, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Nebraska Department of Health and Human Services (DHHS) hereby provides notice that it will add supplemental graduate medical education (GME) payments to eligible teaching hospitals.
These payments will be effective January 1, 2022.
The estimated increase in annual aggregate expenditures is:
FFY22: $61,276,504 ($35,417,819 Federal funds / $25,858,685 General funds)
FFY23: $80,702,005 ($47,280,950 Federal funds / $34,421,055 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 2, 2021
In accordance with the Special Terms and Conditions (STCs) of the Section 1115 Heritage Health Adult (HHA) Demonstration waiver program, the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of its intent to submit a Notification of Termination to the Centers for Medicare & Medicaid Services (CMS), terminating the Section 1115 HHA Demonstration waiver. Due to a lack of approval for the Implementation Plan, specifically the Demonstration Year 2 Community Engagement activities, Nebraska is no longer pursuing implementation of the 1115 HHA Demonstration waiver and will terminate the waiver upon CMS approval. Because the 1115 HHA Demonstration waiver was not implemented, no beneficiaries were transitioned to the waiver authority and were not subject to the waiver requirements. As such, no activity is required to phase-out the demonstration program. The state assumes the transition and phase-out plan requirements as indicated by the 1115 HHA STCs are not applicable in this circumstance. Termination of the 1115 HHA Demonstration waiver will have no impact on Medicaid eligibility or access to services.
The public is invited to comment on MLTC's intent to submit the notification of termination for a period of 30 days. All comments must be received by July 2, 2021.
Comments from the general public may be sent to:
Department of Health and Human Services
Nebraska Medicaid
ATTN: Demonstration Waivers
301 Centennial Mall South
P.O. Box 95026
Lincoln, Nebraska 68509-5026
Email: DHHS.DemonstrationWaivers@nebraska.gov
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 2, 2021
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by July 2, 2021.
The Nebraska Department of Health and Human Services will submit a SPA to transition the Nebraska Basic Alternative Benefit Plan (ABP) and the Nebraska Prime Alternative Benefit Plan (ABP) to one Alternative Benefit Plan called the Nebraska Alternative Benefit Plan (ABP). Currently, the Nebraska Prime ABP provides services to targeted populations of the Adult Medicaid Expansion Group: Medically Frail, age 19-20 years old, and pregnant women. The Nebraska Basic ABP provides services to participants who are enrolled in the Medicaid Adult expansion group who are not Medically Frail, age 19 or 20, or pregnant. Under the new Nebraska ABP effective October 1, 2021, all participants enrolled in the Medicaid Adult expansion group including pregnant women will receive the services equal to those in the current Nebraska Prime ABP.
The Nebraska ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits and all services equal to the Nebraska Medicaid State Plan. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than September 30, 2021.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on June 2, 2021. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by July 2, 2021.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 28, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice of a payment rate change for some Medicaid covered services available to eligible clients in Nebraska. Medicaid will implement a 2.00% increase in provider rates for outpatient services. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2021.
The estimated increase in annual aggregate expenditures for outpatient rates is:
FFY2021: $92,151 ($57,751 Federal funds / $34,400 General funds)
FFY2022: $368,604 ($218,766 Federal funds / $149,838 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 28, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice of a payment rate change for some Medicaid covered services available to eligible clients in Nebraska. Medicaid will implement a 2.00% increase in provider rates for inpatient services. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021). The Medicaid provider rates and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services on or after July 1, 2021.
The estimated increase in annual aggregate expenditures for inpatient rates is:
FFY2021: $87,363 ($54,750 Federal funds / $32,613 General funds)
FFY2022: $349,452 ($207,400 Federal funds / $142,052 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 28, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice regarding intermediate care facility for individuals with developmental disabilities (ICF-DD) rates for state fiscal year 2022.
The updated Medicaid payment rates are effective for services on or after July 1, 2021.
For the rate period of July 1, 2021 through June 30, 2022, the inflation factor for ICF-DD is positive 26.22%.
The estimated increase in annual aggregate expenditures for ICF-DD rates is:
FFY2021: $381,854 ($215,633 Federal funds / $166,221 General funds)
FFY2022: $1,145,560 ($662,134 Federal funds / $483,426 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 28, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice regarding nursing facility rates for state fiscal year 2022. The rate changes are the result of an increase in appropriations by the Nebraska Legislature via LB380 (2021).
The updated Medicaid payment rates are effective for services on or after July 1, 2021.
Nursing Facilities: For the rate period of July 1, 2021 through June 30, 2022, the inflation factor is positive 15.99%.
The estimated increase in annual aggregate expenditures for nursing facility rates is:
FFY2021: $3,069,465 ($1,733,327 Federal funds / $1,336,138 General funds)
FFY2022: $9,208,394 ($5,322,452 Federal funds / $3,885,942 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: February 26, 2021
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan (ABP) to add Medication Assisted Treatment (MAT) services
Nebraska Basic Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. The Nebraska Department of Health and Human Services hereby provides notice of its intent to amend the Alternative Benefit Plan (ABP) to include Medication Assisted Treatment (MAT) services in the 'other 1937 section' of the ABP5. This notice also serves to open the 30-day public comment period. All comments must be received by March 28, 2021.
MAT is provided as defined in the approved state plan 3.1A and if applicable, 3.1B pages. MAT is covered under the Medicaid state plan for all Medicaid beneficiaries who meet the medical necessity criteria for receipt of the service for the period beginning October 1, 2020 and ending September 30, 2025.
The Nebraska Department of Health and Human Services expects to submit this SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2021.
There is no estimated increase or decrease in annual aggregate expenditures as MAT services are existing state plan services and this amendment is to be in compliance with a new federal mandate moving MAT coverage from optional to mandatory for states.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, will not be provided under the Nebraska Basic ABP. These services will be provided in the Nebraska Prime ABP as those eligible individuals in the Adult Expansion Group who are under age 21 will be a targeted group enrolled in the Nebraska Prime ABP.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on February 26, 2021. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by March 28, 2021.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: February 26, 2021
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan (ABP) to add Medication Assisted Treatment (MAT) services
Nebraska Prime Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. The Nebraska Department of Health and Human Services hereby provides notice of its intent to amend the Alternative Benefit Plan (ABP) to include Medication Assisted Treatment (MAT) services in the 'other 1937 section' of the ABP5. This notice also serves to open the 30-day public comment period. All comments must be received by March 28, 2021.
MAT is provided as defined in the approved state plan 3.1A and if applicable, 3.1B pages. MAT is covered under the Medicaid state plan for all Medicaid beneficiaries who meet the medical necessity criteria for receipt of the service for the period beginning October 1, 2020 and ending September 30, 2025.
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2021.
There is no estimated increase or decrease in annual aggregate expenditures as MAT services are existing state plan services and this amendment is to be in compliance with a new federal mandate moving MAT coverage from optional to mandatory for states.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska Prime ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on February 26, 2021. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by March 28, 2021.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: February 26, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice of its intent to submit a state plan amendment (SPA) in accordance with a new federal mandate requiring states to cover Medication Assisted Treatment (MAT) as a benefit under the Medicaid state plan for Medicaid beneficiaries who meet the medical necessity criteria for receipt of the service effective October 1, 2020.
This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by March 28, 2021.
Section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) amends Title 19 of the Social Security Act (SSA) to require state Medicaid programs to include coverage of medication-assisted treatment (MAT) – inclusive of both the drug and the related counseling services and behavioral therapy - for the treatment of Opioid Use Disorder (OUD) for eligible enrollees in the state Medicaid plan and waivers of the state Medicaid plan.
There is no estimated increase or decrease in annual aggregate expenditures as the MAT services are existing state plan services and this amendment is to be in compliance with a new federal mandate moving MAT coverage from optional to mandatory for states.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: January 25, 2021
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice that it will implement targeted rate increases for providers of mental health and behavioral health services, specifically individual psychotherapy, substance use assessment, and day rehabilitation services, as directed in LB 1008.
Effective September 1, 2020.
The estimated increase in annual aggregate expenditures is:
FFY20: $1,952 ($1,068 Federal Funds / $884 General Funds)
FFY21: $23,428 ($13,230 Federal funds / $10,198 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 31, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice that it will implement January 2021 update to healthcare common procedure coding system (HCPCS).
Effective January 1, 2021, the Division will implement the new codes and associated rates.
The estimated increase in annual aggregate expenditures is:
FFY21: $31,211 ($17,625 / $13,586)
FFY22: $41,614 ($24,053 / $17,561)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-471-9092 or e-mail to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 15, 2020
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Basic Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by January 14, 2021.
The Nebraska Department of Health and Human Services provides notice of its intent to submit a SPA to align the Nebraska Basic Alternative Benefit Plan (ABP) to the State's approved 1115 Demonstration Waiver. Currently, the Nebraska Basic ABP provides services to participants who are enrolled in the Medicaid Adult expansion group who are not Medically Frail, age 19 or 20, or pregnant. Under Nebraska's approved 1115 Demonstration Waiver, effective April 1, 2021, all newly enrolled Demonstration Waiver participants will receive services under the Nebraska Basic ABP. This group consists of individuals who do not meet the current targeted populations. Any time a Demonstration Waiver participant does not meet wellness and personal responsibility activities, this individual will be placed into the Nebraska Basic ABP. Beginning in demonstration waiver year 2, community engagement activities will be added to the Demonstration Waiver requirements and Demonstration Waiver participants who do not meet this requirement, or the wellness and personal responsibility activities, will be placed into the Nebraska Basic ABP.
The Nebraska Basic ABP provides eligible individuals in the Adult Expansion Group with access to all of the federally mandated Essential Health Benefits. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The following services are not included in the Nebraska Basic ABP:
- Vision
- Dental
- Over the counter medications
- Pediatric services, including oral and vision care (Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services)
The Nebraska Department of Health and Human Services expects to submit this SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2021.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, pursuant to 42 CFR 440.345, will not be provided under the Nebraska Basic ABP. These services will be provided in the Nebraska Prime ABP as those eligible individuals in the Adult Expansion Group who are under age 21 will be a targeted group enrolled in the Nebraska Prime ABP.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on December 15, 2020. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by January 14, 2021.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 15, 2020
Medicaid State Plan Amendment (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Prime Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPA and also serves to open the 30-day public comment period. All comments must be received by January 14, 2021.
The Nebraska Department of Health and Human Services will submit a SPA to align the Nebraska Prime Alternative Benefit Plan (ABP) to the State's approved 1115 Demonstration Waiver. Currently, the Nebraska Prime ABP provides services to targeted populations of the Adult Medicaid Expansion Group: Medically Frail, age 19-20 years old, and pregnant women. Under the approved 1115 Demonstration Waiver effective April 1, 2021, individuals who do not meet the current targeted populations must meet wellness initiatives and personal responsibility activities, and beginning in demonstration year 2 participate in certain community engagement activities in order to receive coverage under the Nebraska Prime ABP.
The Nebraska Prime ABP provides eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits. These Essential Health Benefits include all services provided in the Nebraska Basic Alternative Benefit Plan with the inclusion of:
- Vision
- Dental
- Over the counter medications
- Pediatric services, including oral and vision care (Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services)
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than March 31, 2021.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska Prime ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed SPA to the appropriate tribal contacts on December 15, 2020. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by January 14, 2021.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 6, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice of Medicaid payment rate change for some Medicaid covered services for Nebraska eligible clients. Medicaid will implement a 2.00% increase in provider rates for both inpatient and outpatient services and an additional 2.00% increase for behavioral health providers. The rate increases are the result of an increase in appropriations by the Nebraska Legislature via LB294 (2019). The current and revised rate and fee schedules are available online for public view at the page below.
Provider Rates and Fee Schedules
The updated Medicaid payment rates are effective for services with a date of service on or after July 1, 2020.
The estimated increase in annual aggregate expenditures for outpatient rates is:
FFY2020: $62,056 Federal Funds Fiscal Impact (July 1, 2020 to September 30, 2020)
FFY2021: $256,161 Federal Funds Fiscal Impact (October 1, 2020 to September 30, 2021)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: August 31, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of Medicaid and Children's Health Insurance Program (CHIP) payment rate change for behavioral health and mental health services. An increase in provider rates will be implemented pursuant to the appropriation by the Nebraska Legislature via LB1008 (2020).
Effective September 1, 2020, MLTC will implement a rate increase for both Medicaid and CHIP providers of mental health and behavioral health services. Services include, but are not limited to, day rehabilitation services, mental health individual sessions, substance use disorder individual sessions, substance use disorder assessments, therapeutic community services, and psychiatric residential rehabilitation.
The estimated increase in annual aggregate expenditures for Medicaid is:
FFY20: $737,007 (FF: $412,945 / GF: $324,062) (9-1-20 to 9-30-20)
FFY21: $8,844,073 (FF: $4,955,334 / GF: $3,888,739) (10-1-20 to 9-30-21)
The estimated increase in annual aggregate expenditures for CHIP is:
FFY20: $68,093 (FF: $47,134.333 / GF: $20,959) (9-1-20 to 9-30-20)
FFY21: $817,122 (FF: $565,612 / GF: $251,510) (10-1-20 to 9-30-21)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: August 31, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice that it will implement an increase in rates for providers of halfway house services. Effective September 1, 2020, an increase in provider rates for halfway home services will be implemented pursuant to the appropriation by the Nebraska Legislature via LB1008 (2020).
The estimated increase in annual aggregate expenditures is:
FFY20: $41,164 (FF: $23,052 / GF: $18,112) (9-1-20 through 9-30-20)
FFY21: $493,971 (FF: $276,624 / GF: $217,347) (10-1-20 through 9-30-21)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 30, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice of Medicaid payment rate change for some Medicaid covered services for Nebraska eligible clients. Medicaid will implement a 2.00% increase in provider rates for both inpatient and outpatient services and an additional 2.00% increase for behavioral health providers. The rate increases are the result of an increase in appropriations by the Nebraska Legislature via LB294 (2019). The current and revised rate and fee schedules are available online for public view at the page below.
Medicaid Provider Rates
The updated Medicaid payment rates are effective for services with a date of service on or after July 1, 2020.
The estimated increase in annual aggregate expenditures for outpatient rates is:
FFY2020: $1,800,255 Federal Funds Fiscal Impact (7/1/2020 to 9/30/2020)
FFY2021: $8,020,015 Federal Funds Fiscal Impact (10/1/2020 to 9/30/2021)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 30, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice of Medicaid payment rate change for some Medicaid covered services for Nebraska eligible clients. Medicaid will implement a 2.00% increase in provider rates for both inpatient and outpatient services and an additional 2.00% increase for behavioral health providers. The rate increases are the result of an increase in appropriations by the Nebraska Legislature via LB294 (2019). The current and revised rate and fee schedules are available online for public view at the page below.
Medicaid Provider Rates
The updated Medicaid payment rates are effective for services with a date of service on or after July 1, 2020.
The estimated increase in annual aggregate expenditures for inpatient rates is:
FFY2020: $1,076,765 Federal Funds Fiscal Impact (7/1/2020 to 9/30/2020)
FFY2021: $4,796,913 Federal Funds Fiscal Impact (10/1/2020 to 9/30/2021)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICEPosted: June 29, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice that a rate increase for the Traumatic Brain Injury Waiver will be implemented.
Effective July 1, 2020, a rate increase will be implemented for the Traumatic Brain Injury Waiver provider(s) after rate rebasing required by the Centers for Medicare and Medicaid Services and applying the increase appropriated by the Nebraska Legislature.
The estimated increase in annual aggregate expenditures is:
FFY20: $14,193.30 (Federal funds $7,766.57/ General funds $6,416.73)
FFY21: $56,773.20 (Federal funds $31,066.30/ General funds $25,706.87)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 24, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice regarding intermediate care facility for individuals with developmental disabilities (ICF/DD) rates for state fiscal year 2021.
ICF/DD: For the rate period of July 1, 2020 through June 30, 2021, the inflation factor is positive 25.03%.
ICF/DD federal fiscal impact: $819,399
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402)471-9092![]( "Call: (402)471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 24, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice regarding nursing facility rate methodology and rates for state fiscal year 2021.
Nursing facilities: For the rate period of July 1, 2020 through June 30, 2021, Medicaid rates are computed using the new methodology summarized at this link. The inflation factor is positive 1.51%.
Nursing facilities federal fiscal impact: $8,094,059
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 22, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services, Division of Medicaid and Long-Term Care hereby provides notice that it will implement the federally approved Alternative Payment Methodology (APM) for dental services provided by Federally Qualified Health Centers (FQHCs).
Effective July 1, 2020, FQHCs' dental services will be reimbursed the APM rates. This methodology allows for the use of more recent cost reports as the basis for the cost-per-visit for each FQHC, and ultimately allows for a closer alignment of reimbursement to the FQHC's actual costs.
The estimated increase in annual aggregate expenditures is:
FFY20: $656,427
FFY21: $2,625,710
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: June 3, 2020
The Centers for Medicare & Medicaid Services (CMS) has issued Guidance for Infection Control and Prevention of COVID-19. This guidance directs nursing homes to restrict significantly visitors and nonessential personnel from entering nursing homes in order to protect nursing home residents. Recognizing that visitor restrictions may be difficult for residents and their families, the Nebraska Department of Health and Human Services (DHHS) allowed nursing homes in Nebraska to apply for the use of Civil Money Penalty (CMP) Reinvestment funds to purchase adaptive communicative technologies for their residents. This public notice is being posted in accordance with 42 CFR 488.433(e)(2) to provide information regarding the amounts and recipients of funds awarded by DHHS.
CMP Payments Summary
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: May 8, 2020
SEEKING PUBLIC COMMENT:
Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) is required to give public notice related to the state's plan to amend a Medicaid Home and Community-Based Services (HCBS) waiver for individuals with who are disabled or aged.
The Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) is developing an amendment to implement changes to the 1915(c) Home and Community Based (HCBS) Aged and Disabled (AD) Waiver.
The 30-day public comment period is from May 12, 2020 – June 11, 2020.
The following lists a summary of the proposed changes:
- Remove nutrition as a service: The HCBS Waiver for Aged and Adults and Children with Disabilities currently provides Nutrition service. This service is now available under the Medicaid State Plan and will be removed from the waiver.
- Re-locate and update Quality Improvement Performance Measures related to non-licensed/certified providers: Through technical assistance with U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) it was determined that the providers that were currently being counted as non-licensed/certified providers should be counted as non-licensed/non-certified. This update is comprised of moving three performances measures currently located under Sub-Assurance a.: The State verifies that providers initially and continually meet required licensure and/or certification standards and adhere to other standards prior to their furnishing waiver services to Sub Assurance b.: The State monitors non-licensed/non-certified providers to assure adherence to waiver requirements.
- Add the Medicaid expansion group as individuals who can be eligible for the waiver: The new Medicaid eligibility group covered by Medicaid expansion, referred to as Heritage Health Adult, will be listed as a group that will qualify for the waiver provided they meet all other eligibility criteria for the waiver. The go live date for Medicaid expansion is set for 10/1/2020.
The draft HCBS waiver application can be viewed on the Department's website.
A hard copy of the waiver applications can also be requested via mail, email, or by phone at (402) 471-9156.
Interested persons are invited to submit their written comments to the Department. Written comments must be received by June 11, 2020.
- Public comments may be submitted to the designated email address: DHHS.HCBSPublicComments@nebraska.gov
- Faxed to (402) 471-9092
- Or mailed to:
Department of Health and Human Services
Nebraska MLTC
ATTN: Donna Brakenhoff
301 Centennial Mall South
P.O. Box 95026
Lincoln, NE 68509-5026
- Comments will also be accepted at the public meetings listed below.
| Date | City | Location | Time |
| May 19, 2020 | Statewide Webinar | Please join the Zoom meeting AND by phone. Join Zoom Meeting: http://go.unl.edu/adwaiver-amendment
Join by phone: Toll-free: (888) 820-1398 Participant code: 3925547# | 9:00 - 10:00 AM CST |
| May 21, 2020 | Statewide Webinar | Please join the Zoom meeting AND by phone. Join Zoom Meeting: http://go.unl.edu/adwaiver-amendment
Join by phone: Toll-free: (888) 820-1398 Participant code: 3925547# | 5:00 – 6:00 PM CST |
After the public comment period, when submitted to CMS, the HCBS waiver will include a summary of the public comments received during the public input process, and if any comments were not adopted, the reasons why. The summary will also specify any modifications made to the waiver as a result of the public input process.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: April 29, 2020
SEEKING PUBLIC COMMENT:
Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) is required to give public notice related to the state's plan to amend two Medicaid Home and Community-Based Services (HCBS) 1915(c) Waivers for individuals with developmental disabilities. The 30-day public comment period is from May 1, 2020 – May 30, 2020.
Each draft of the proposed amended HCBS waiver application can be viewed on the Department's website, in its entirety with proposed changes highlighted in the Main-Introduction section, Appendix B, and Appendix G. There will be a WebEx presentation of the proposed changes on Tuesday, May 19, 2020 from 1:00pm to 2:00pm. Information for accessing the WebEx is posted at:
Developmental Disabilities Public Comments
A hard copy of the amended waiver applications can also be requested via mail, email, or by phone at (877) 667-6266.
Interested persons are invited to submit their written comments to the Department. Written comments must be postmarked or received by 5:00 p.m., on May 30, 2020. Public comments may be submitted to the designated email address: DHHS.DDWaiverQuestions@nebraska.gov; faxed to (402) 471-8792![]( "Call: (402) 471-8792")
; or sent to Department of Health and Human Services - DDD, 301 Centennial Mall South, P.O. Box 98947, Lincoln, NE 68509-8947.
After the public comment period, when submitted to the Centers for Medicare and Medicaid, the HCBS waivers will include a summary of the public comments received during the public input process, and if any comments were not adopted, the reasons why. The summary will also specify any modifications made to the waiver as a result of the public input process.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: April 27, 2020
In accordance with 42 CFR 431.408, the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) hereby provides notice of MLTC's intent to submit to the Centers for Medicare and Medicaid Services (CMS) an amendment to the state's Section 1115 Medicaid Demonstration Waiver for Substance Use Disorder (SUD) Services. This 1115 SUD demonstration, effective July 1, 2019, provides MLTC with the authority to receive federal Medicaid financial participation (FFP) for the coverage of SUD treatment-related stays in Institutions for Mental Diseases (IMDs) for adults age 21-64. More specifically, the authority allows MLTC the flexibility to include in managed care capitation rate development IMD stays that exceed the 15-day limit found in 42 CFR 438.6(e). The proposed amendment will extend this coverage to beneficiaries who are able-bodied adults age 19-64 with income up to 138% of the Federal Poverty Line (commonly referred to as the “adult expansion population" as defined in 42 CFR 435.119) beginning October 1, 2020.
DHHS is allowing 30 calendar days for public review and comment on the demonstration amendment. Please respond no later than May 27, 2020.
Comments may be submitted to:
Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care
Attn. Todd Baustert
Lincoln, Nebraska 68509-5026
Fax (402) 471-9092 or e-mail to DHHS.SUDWaiver@nebraska.gov
In response to current public health directives related to COVID-19, DHHS will conduct two public hearings on the demonstration amendment as online webinars with a toll-free teleconference line.
| Hearing/Meeting Date | Time | Webinar | Teleconference # |
| Thursday, April 30, 2020 | 2:00pm – 3:00pm central time | Link to the Webinar
| Toll-free conference line: 1 (888) 820-1398 Attendee Code: #7300221 |
| Wednesday, May 6, 2020 | 2:00pm – 3:00pm central time | Link to the Webinar | Toll-free conference line: 1 (888) 820-1398 Attendee Code: #7300221 |
For more information on this amendment including the full public notice, visit the following webpage: Substance Use Disorder Demonstration Program.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: March 16, 2020
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice that it will implement changes to allow the services of escorts for non-emergency medical transportation when deemed medically necessary. Nebraska Medicaid will cover travel expenses for the client and escort including transportation, meals, and lodging.
The anticipated effective date is April 1, 2020.
The estimated increase in annual aggregate expenditures is:
FFY20: $250,000 ($136,800 Federal funds / $113,200 General funds)
FFY21: $324,090 ($204,046 Federal funds/ $120,044 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: February 28, 2020
DHHS Seeking Public Comment on the Traumatic Brain Injury Waiver
New Rate Methodology, Removal of Duplicate Performance Measure and Addition of Heritage Health Adult Population
Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) is required to give public notice related to the state's plan to renew a Medicaid Home and Community-Based Services (HCBS) waiver for individuals with developmental disabilities.
The Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) is developing an amendment to implement changes to the 1915(c) Home and Community Based (HCBS) Traumatic Brain Injury (TBI) Waiver.
The 30-day public comment period is from February 28, 2020 – March 29, 2020.
The following lists a summary of the proposed changes:
- Include the new Medicaid eligibility group covered by Medicaid expansion as a group eligible, provided the individuals meet all other eligibility criteria for the TBI waiver.
- Remove a duplicative performance measure that reviews claims compared to eligible participants.
- CMS required the state to complete the process to rebase and revise the rate methodology and rates for the services provided under this waiver. This included a review of the rate allowed for room and board, as well a review of medical transportation cost components, and provider retainer payments.
The draft HCBS waiver application can be viewed on the Department's website, in its entirety or by appendix, at:
http://dhhs.ne.gov/Documents/TBI%20Waiver%20Application.pdf
A hard copy of the waiver applications can also be requested via mail, email, or by phone at 402-471 8091.
Interested persons are invited to submit their written comments to the Department. Written comments must be received by March 29, 2020.
- Public comments may be submitted to the designated email address: DHHS.HCBSPublicComments@nebraska.gov.
- faxed to (402) 471-9092
- Or mailed to:
Department of Health and Human Services
Nebraska Medicaid
ATTN: Rebecca Hoffman
301 Centennial Mall South
P.O. Box 95026
Lincoln, NE 68509-5026
Comments will also be accepted at the public meetings listed below.
| Date | City | Location | Time |
| March 4, 2020 | Statewide Webinar | Please join the Zoom meeting AND by phone. Join Zoom Meeting: http://go.unl.edu/publiccomment Join by phone: Toll-free: 888-820-1398 Participant code: 3925547# | 1:30 -3:30 PM Central |
| March 10, 2020 | Statewide Webinar | Please join the Zoom meeting AND by phone. Join Zoom Meeting: http://go.unl.edu/publiccomment
Join by phone: Toll-free: 888-820-1398 Participant code: 3925547# | 5:30 -7:30 PM Central |
March 18, 2020
| Lincoln or Statewide Webinar | State Office Building – Lower Level B Come in Person, Join the Zoom meeting, or Join by Phone. Join Zoom Meeting: http://go.unl.edu/publiccomment
Join by phone: Toll-free: 888-820-1398 Participant code: 3925547# | 1:30 – 3:30 PM Central |
After the public comment period, when submitted to the Centers for Medicare and Medicaid, the HCBS waiver will include a summary of the public comments received during the public input process, and if any comments were not adopted, the reasons why. The summary will also specify any modifications made to the waiver as a result of the public input process.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 19, 2019
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement a provider rate increase for LPN Private Duty Nursing services (codes S9124 and S9124 with Modifier TG) as a result of a rate study.
The anticipated effective date is January 1, 2020.
The estimated increase in annual aggregate expenditures is:
FFY20: $979,052 ($535,737 Federal Funds / $443,315 General Funds)
FFY21: $1,322,692 ($746,924 Federal Funds / $575,768 General Funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 18, 2019
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement Opioid Treatment Program (OTP) as a new Medicaid state plan covered service. The OTP service offers community-based, non-residential rehabilitative services for individuals diagnosed with an opioid use disorder, as defined in the Diagnostic Statistical Manual. The OTP service includes rehabilitative services to administer opioid treatment medication and to alleviate the adverse medical, psychological, or physical effects incident to opioid addiction.
The anticipated effective date is January 1, 2020.
The estimated increase in annual aggregate expenditures is:
FFY20: $1,268,400 ($694,068 Federal funds / $574,332 General funds)
FFY21: $1,713,600 ($968,355 Federal funds / $745,245 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: December 18, 2019
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement Medically-monitored Inpatient Withdrawal Management (ASAM Level 3.7-WM) as a new Medicaid state plan covered service. Medically-monitored Inpatient Withdrawal Management is an organized service delivered by medical and nursing professionals, which provide for 24-hour medically supervised evaluation under a defined set of physician-approved policies and physician-monitored procedures or clinical protocols. This level provides care to patients whose withdrawal signs and symptoms are sufficiently severe to require 24-hour residential care.
The anticipated effective date is January 1, 2020.
The estimated increase in annual aggregate expenditures is:
FFY20: $2,265,500 ($1,239,408 Federal funds / $1,025,592 General funds)
FFY21: $3,060,000 ($1,729,206 Federal funds / $1,330,794 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: November 26, 2019
This notice is given in compliance with 42 CFR 447.205 and Section 1902(a)(13)(A) of the Social Security Act. The Department of Health and Human Services Division of Medicaid and Long-Term Care hereby provides notice that it will implement changes for chiropractic services. Current maximum number of visits for adults and children will be removed. Chiropractic treatment by means of manual manipulation for the Medicaid-eligible population, regardless of age, will now be based on medical necessity. The changes also include new coverage guidelines to be more consistent with the licensure scope of practice for chiropractors.
The anticipated effective date is January 1, 2020. The estimated increase in annual aggregate expenditures:
FFY21: $3,213,000 ($1,815,666 Federal funds / $1,397,334 General funds)
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email DHHS.MedicaidSPA@nebraska.gov. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: October 25, 2019
Medicaid State Plan Amendments (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Basic Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPAs and also serves to open the 30-day public comment period. All comments must be received by November 26, 2019.
The Nebraska Department of Health and Human Services provides notice of its intent to submit a State Plan Amendment (SPA) to define the Alternative Benefit Plan (ABP) that will be used to allow for expansion of Medicaid eligibility to individuals aged 19‐64 with incomes at or below 138% of the Federal Poverty Level (FPL) who are not enrolled in or eligible for Medicare, consistent with the expanded eligibility criteria as defined by the Affordable Care Act (referred to here as the “Adult Expansion Group").
This ABP (referred to here as “Nebraska Basic ABP") will be applicable to individuals in the Adult Expansion Group who are eligible for Nebraska's Medicaid program and who do not meet criteria for the Nebraska Prime ABP as established in the State's proposed 1115 Demonstration Waiver. Under the proposed 1115 Demonstration Waiver, all newly enrolled individuals will receive services under the Nebraska Basic ABP. Under the proposed 1115 Demonstration Waiver, all newly enrolled individuals and individuals who do not meet wellness initiatives and personal responsibility activities will receive services under the Nebraska Basic ABP. Beginning in waiver demonstration year 2, individuals not participating in community engagement activities will also receive services under the Nebraska Basic ABP.
Once approved, the Nebraska Basic ABP will provide eligible individuals in the Adult Expansion Group with access to all of the federally mandated Essential Health Benefits. These Essential Health Benefits include the following services:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
The following services are not included in the Nebraska Basic ABP:
- Vision
- Dental
- Over the counter medications
- Pediatric services, including oral and vision care (Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services)
The Nebraska Department of Health and Human Services expects to submit this SPA to the Centers for Medicare and Medicaid Services no later than December 15, 2019.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, pursuant to 42 CFR 440.345, will not be provided under the Nebraska Basic ABP. These services will be provided in the Nebraska Prime ABP as those eligible individuals in the Adult Expansion Group who are under age 21 will be a targeted group enrolled in the Nebraska Prime ABP.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed State Plan Amendment to the appropriate tribal contacts on October 25, 2019. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092 or email to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by November 26, 2019.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: October 25, 2019
Medicaid State Plan Amendments (SPA) regarding an Alternative Benefit Plan for an Expanded Adult Population
Nebraska Prime Alternative Benefit Plan
Notice is hereby given, in accordance with 42 CFR 440.386. This notice provides a summary of the purpose of the SPAs and also serves to open the 30-day public comment period. All comments must be received by November 26, 2019.
The Nebraska Department of Health and Human Services provided notice of its intent to submit a State Plan Amendment (SPA) to define the Alternative Benefit Plan (ABP) that will be used to allow for expansion of Medicaid eligibility to individuals aged 19‐64 with incomes at or below 138% of the Federal Poverty Level (FPL) who are not enrolled in or eligible for Medicare, consistent with the expanded eligibility criteria as defined by the Affordable Care Act (referred to here as the “Adult Expansion Group"). This notice was provided on February 25, 2019.
Notice is hereby given, in accordance with 42 CFR 440.386, to provide a summary of an amendment to the previous SPA and notice provided.
The previous ABP noticed on February 25, 2019 will now be referred to as the “Nebraska Prime ABP". The Nebraska Prime ABP will be applicable to individuals in the Adult Expansion Group who are eligible for Nebraska's Medicaid program and who meet criteria established in the State's proposed 1115 Demonstration Waiver. Under the proposed 1115 Demonstration Waiver, individuals must meet wellness initiatives and personal responsibility activities, and beginning in demonstration year 2 participate in certain community engagement activities in order to receive coverage under the Nebraska Prime ABP.
The Nebraska Prime ABP will provide services to the following targeted populations of the Adult Expansion Group:
- Medically frail;
- Age 19-20 years old; and
- Pregnant women.
Once approved, the Nebraska Prime ABP will provide eligible individuals in the Adult Expansion Group with access to the federally mandated Essential Health Benefits. These Essential Health Benefits include all services provided in the Nebraska Basic Alternative Benefit Plan with the inclusion of:
- Vision
- Dental
- Over the counter medications
- Pediatric services, including oral and vision care (Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services)
The Nebraska Department of Health and Human Services expects to submit the amended SPA to the Centers for Medicare and Medicaid Services no later than December 15, 2019.
Pursuant to 42 CFR 440.345, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services will be provided in the Nebraska Prime ABP to those eligible individuals in the Adult Expansion Group who are under age 21 as required by law and regulation, and consistent with current state policy regarding the delivery of these services.
The section 1937 coverage option for the ABP will be Secretary-Approved Coverage that is based on, and consistent with, the benefits provided in Nebraska's approved state Medicaid plan. The base benchmark plan will be the largest plan by enrollment of the three largest small group insurance products in Nebraska's small-group market.
Consistent with federal law and the Nebraska Medicaid State Plan, the State Medicaid Director provided written notice regarding the proposed State Plan Amendment to the appropriate tribal contacts on October 25, 2019. In accordance with the State Plan, additional information regarding the proposed changes will be provided to the tribal contacts upon request, and consultation will occur as requested or as otherwise appropriate.
Comments pertaining to the aforementioned may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax (402) 471-9092![]( "Call: (402) 471-9092")
or e-mail to DHHS.MedicaidSPA@nebraska.gov. Non-electronic copies will be made available for review at each local office of the Department of Health and Human Services. All comments must be received by November 26, 2019.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC NOTICE
Posted: October 25, 2019
Section 1115 Heritage Health Adult Expansion Demonstration
Improving Health Outcomes and Encouraging Life Successes for Adult Medicaid Beneficiaries.
In November 2018, Nebraska voters approved Initiative 427, electing the federal option to provide Medicaid coverage to otherwise ineligible adults up to 138% of the federal poverty level under the Patient Protection and Affordable Care Act (ACA). The Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care (MLTC) administers the Nebraska Medicaid program and is responsible for the implementation of this adult Medicaid expansion project.
MLTC is providing this abbreviated public notice of its intent to: (1) request, on or before December 20, 2019, approval of a Section 1115 demonstration project from the Centers for Medicare & Medicaid Services that will implement Medicaid expansion through a program that will be known as “Heritage Health Adult" (“HHA"); (2) hold public hearings to receive comments on the Section 1115 demonstration application.
Summary of HHA Program Features
Unlike existing Medicaid-eligible individuals, HHA adults will have a tiered benefit system through which all eligible HHA beneficiaries will receive either the “Basic" benefits package or the “Prime" benefits package. The Basic benefits package includes comprehensive medical, behavioral health, and prescription drug coverage. The Prime benefits package is the Basic benefits package plus vision, dental, and over-the-counter medication. Both benefit packages will be provided through the State's current managed care entities.
All beneficiaries newly eligible for Medicaid under the HHA program will receive the Basic benefits package for the initial six-month benefit tier period.
HHA beneficiaries will receive the Prime benefits package if:
- They are medically frail; or
- They are age 19 or 20; or
- They are a pregnant woman eligible under expansion; or
- Beginning in Demonstration Year (DY) 1, they engage in the wellness initiatives and personal responsibility activities. Beginning in DY2, HHS beneficiaries must also participate in community engagement activities, including but not limited to, employment, job-seeking activities, and educational activities. HHA beneficiaries who do not engage in these activities will be assigned to the Basic benefits package.
In addition to the tiered benefit structure, MLTC will encourage timely enrollment and promote increased continuity of care through a waiver of retroactive eligibility for HHA and most other adult Medicaid beneficiaries, with the exception of pregnant women, individuals dually-eligible for Medicare and Medicaid, and individuals in nursing facilities.
Finally, MLTC plans to facilitate and encourage more widespread enrollment in private health insurance through a future amendment to the demonstration.
Public Meetings and Comment
The public is invited to review and comment on the State's demonstration request.
Paper copies of the full public notice document and a draft of the amendment application can be picked up during regular business hours at the Department of Health and Human Services, 301 Centennial Mall South, Lincoln, Nebraska 68509
Comments will be accepted 30 days from the publication of this notice. The comment period ends November 26, 2019. Comments may be sent to:
Department of Health and Human Services
Nebraska Medicaid
ATTN: HHA Waiver
301 Centennial Mall South
P.O. Box 95026
Lincoln, Nebraska 68509-5026
Comments may also be sent by email to DHHS.HHAWaiver@Nebraska.gov.
Public hearings are scheduled at the following times/locations:
| Meeting Date (Agenda) | Time | Location | Call-in Information |
| Tuesday, October 29, 2019 | 7 pm - 8:30 pm MDT | Board Room, Scottsbluff High School 313 E 27th St, Scottsbluff NE 69361 | (844) 588-2804
Meeting ID: 704387476 |
| Wednesday, October 30, 2019 | 6:45 pm - 8:15 pm CDT | South Platte Room, Kearney Public Library
2020 1st Ave, Kearney NE 68847 | (844) 588-2804
Meeting ID: 985819573 |
Thursday, November 7, 2019
| 6 pm - 7:30 pm CST | Meeting Room A, Norfolk Public Library
308 W Prospect Ave, Norfolk, NE 68701 | -- |
| Tuesday, November 12, 2019 | 7 pm - 8:30 pm CST | Room 132, UNO College of Public Affairs and Community Service
6320 Maverick Plaza, Omaha, NE 68182 | (888) 820-1398
Attendee code: 7300221 |
Please note: Spoken comments will be accepted over the phone at the Kearney meeting on October 30. For the other meetings with call-in information, the phone line will be open as listen-only for callers. We would encourage those calling into the Scottsbluff or Omaha meetings to submit written comments.
After the State reviews comments submitted during this state public comment period, it will submit a revised application to CMS. Interested parties will also have opportunity to officially comment during the federal public comment period after CMS finds the application and public notice requirements met.