Nebraska Medicaid Submits 1135 Waiver Application

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Julie Naughton, Office of Communications, (402) 471-1695 (office); (402) 405-7202 (cell); julie.naughton@nebraska.gov

Lincoln – Nebraska Medicaid has submitted an 1135 Waiver application to the federal government as part of the Department of Health and Human Services' response to the ongoing COVID-19 pandemic.

Section 1135 is a part of the Social Security Act that allows the federal government to waive certain federal laws in the event of an emergency to ensure health care services are able to continue through the emergency.

“Following the president's emergency declaration related to COVID-19, this waiver was one tool made available to states to respond to the pandemic," said Jeremy Brunssen, interim director of the Division of Medicaid and Long-Term Care. “This waiver will give Nebraska Medicaid certain flexibilities to make sure Medicaid beneficiaries are able to continue to receive needed health care services through the emergency." 

There are six main ways this waiver will affect Nebraska's Medicaid program, outlined below. For each of these flexibilities, Nebraska Medicaid is providing guidance to providers, contractors and other stakeholders on the specific requirements that will be temporarily waived for the duration of the COVID-19 emergency.

1. It will provide flexibility to waive certain provider enrollment criteria, such as revalidations and site visits, through the public health emergency.
2. It will provide flexibility to waive the annual renewal of Pre-Admission Screening and Annual Resident Review (PASRR, levels 1 and 2) for nursing facility residents for 30 days and provide other flexibilities around these requirements.
3. It will extend the time beneficiaries have available to request state fair hearings and allow Nebraska Medicaid flexibility in scheduling hearings and issuing state fair hearing decisions.
4. It will allow facilities flexibility to evacuate their patients and provide care in alternative settings if needed.
5. It will provide flexibility regarding the requirements around public notices and tribal consultation for disaster relief state plan amendments and waivers.
6. It will provide flexibility to waive prior authorizations for services for Nebraska Medicaid's fee-for-service beneficiaries, when clinically appropriate.

This waiver will be in effect until the public health emergency related to COVID-19 is declared to be over.

DHHS invites those with questions or concerns to reach out at DHHS.MLTCExperience@Nebraska.gov