Upcoming Public Hearings on
Proposed DHHS Regulations
 
Public Notices of Proposed
Medicaid Payment Rate Changes  

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Interested persons are invited to submit written comments or to attend and comment at the hearing. Written comments must be postmarked or received by 5:00 p.m. CT the day of the hearing and should be sent to DHHS Legal Services, 301 Centennial Mall South, P.O. Box 95026, Lincoln, NE 68509-5026, faxed 402-742-2382, or e-mailed to DHHS.RulesandRegs@nebraska.gov. Copies of written comments and names of persons submitting them will be available after the hearing from DHHS as above.

Draft copies of the regulations and the estimated schedule for rulemaking are available at DHHS as above, phone 402-471-8223, and at the office of the Secretary of State, Regulations Division, Room 1305, State Capitol, Lincoln, NE 68509, phone 402-471-2385. The draft fiscal impact statement for these regulations is available at DHHS as above. Draft regulations are be available online at http://www.sos.ne.gov.
 
If auxiliary aids or reasonable accommodations are needed to participate in a hearing, please call 402-471-8223. For persons with hearing impairments, please call DHHS at 402-471-9570 (voice and TDD) or the Nebraska Relay System at 711 or 800-833-7352 TDD at least 2 weeks before the hearing date. This notice is given in compliance with Neb. Rev. Stat. Section 84-907.
 
The link for each hearing date below will take you to the Notice of Public Hearings for that date.
Hearing Date      Subjects
Thursday September 18, 2014 Licensure of Mental Health Professions
Thursday October 16, 2014 ​Medicaid Home Health Services Cost Comparison
Thursday October 16, 2014 ​Medicaid Psychiatric Residential Rehab Bed Limit
Public Notice
(published 7/31/14)
​Hospital Supplemental Payment

Public Notice
(published 6/9/14)

​SFY 15 Rates
Public Notice
(published 6/7/12)
​​Amended Indian Health Services Nursing Facility Medicaid Reimbursement Methodology

 


Hearing
10:00 a.m. CT
Thursday, September 18, 2014
State Office Building, Lower Level Conf. Room A
301 Centennial Mall South, Lincoln, NE
 
The Department of Health and Human Services (DHHS) Division of Public Health is holding this hearing to accept comments on proposed changes to regulations related to the licensure/certification of independent mental health practitioners, mental health practitioners, marriage and family therapists, professional counselors, and social workers. These regulations are found in Title 172 Chapter 94 of the Nebraska Administrative Code (NAC). 
 
This is a rewrite of the chapter to reflect the provisions of the Mental Health Practice Act, the Uniform Credentialing Act, and state law requiring verification of lawful presence.  Also included are: 
  • Provisions for technology-assisted services;
  • Revised definitions of terms including approved programs, client/patient or client system, direct client contact, qualified physician, qualified supervisor, supervised experience, and others;
  • Provisions for licensure of independent mental health practitioners;
  • Revised unprofessional conduct standards including the adoption of a code of ethics addressing competence, confidentiality, disclosure of confidential information, discrimination, dual relationships, professional records, professional relationships, referrals, sexual harassment, sexual intimacy, and students and supervisees;
  • Removal of fees and replacement with a reference to their location in 172 NAC 2; and
  • Various minor updates and clarifications. 
The previous rulemaking on these regulations, with public hearings in 2008, 2009, and 2010, is being terminated.
 
Authority for these regulations is found in the Mental Health Practice Act, the Uniform Credentialing Act, and Neb. Rev. Stat. Section 81-3117(7).
 
Written comments must be postmarked or received by 5:00 p.m. CT on September 18, 2014  

Hearing
10:00 a.m. CT
Thursday, October 16, 2014
State Office Building, Lower Level Conf. Room A
301 Centennial Mall South, Lincoln, NE
 
The Department of Health and Human Services (DHHS) Division of Medicaid and Long-Term Care is holding this hearing to accept comments on a proposed change to regulations related to Medicaid payment for home health services.  These regulations are found in Title 471 Chapter 9 Section 003 of the Nebraska Administrative Code (NAC). 
 
The proposed change will remove the current requirement for DHHS to compare the costs of multiple home health services for an individual to the cost of nursing facility care and to recommend nursing facility care if the home health costs exceed nursing facility costs. 
 
Authority for these regulations is found in the Medical Assistance Act and Neb. Rev. Stat. Section 81-3117(7).

Written comments must be postmarked or received by 5:00 p.m. CT on October 16, 2014 

Hearing
11:00 a.m. CT
Thursday, October 16, 2014
State Office Building, Lower Level Conf. Room A
301 Centennial Mall South, Lincoln, NE
 
The DHHS Division of Medicaid and Long-Term Care is holding this hearing to accept comments on proposed changes to regulations related to Medicaid payment for psychiatric residential rehabilitation services.  These regulations are found in Title 471 Chapter 35 Section 004 of the NAC.
 
Current regulations limit Medicaid payment for these services to licensed facilities with no more than eight beds.  The proposed change will increase that limit to 15 beds and will also eliminate the current provisions for waiver of the bed limitation.
 
Authority for these regulations is found in the Medical Assistance Act and Neb. Rev. Stat. Section 81-3117(7).
Written comments must be postmarked or received by 5:00 p.m. CT on October 16, 2014 

 
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
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 (DHHS) Division of Medicaid and Long Term Care hereby provides notice of a proposed change to Medicaid hospital payment policy to establish an annual supplemental payment for inpatient and outpatient hospital services provided by the Nebraska Medical Center.  
 
The supplemental payment will be equal to the difference between Medicaid fee-for-service claims paid and the cost of the services as established under Medicare payment principles pursuant to 42 CFR 447.321 and 42 CFR 447.272.  This payment would be made in addition to Medicaid payments that are otherwise made to the Nebraska Medical Center by Medicaid. 
 
The total increased expenditures to the Children’s Health Insurance (CHIP) and Medicaid Programs as a result of the inpatient and outpatient hospital supplemental payment to the Nebraska Medical Center is $16,900,000 with $7,700,000 from General Funds and $9,200,000 from Federal match for FY15. 
 
A draft is available for viewing at each DHHS local office.  Comments may be submitted to and reviewed by the public at DHHS Legal Services, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-742-2382 or e-mail to DHHS.RulesandRegs@nebraska.gov.  

 
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
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 2.25 percent provider rate increase effective July 1, 2014. The rate increase is the result of an increase in appropriations by the Nebraska Legislature in LB905 (2014).
The rate increase will exclude enhanced primary care procedure codes, prescription drugs, clinical laboratory services, injectable medications, Critical Access Hospitals, Rural Health Clinics, Federally Qualified Health Centers, and Indian Health Services (IHS).
The total increased expenditures as a result of a 2.25 percent rate increase to the Children’s Health Insurance (CHIP) and Medicaid Programs is $30,002,204 with $13,750,854 from General Funds and $16,251,350 from Federal match.
The rate change is reflected in the Nebraska Medicaid Practitioner Fee Schedules and is part of the rebasing for Nursing Facility and ICF/DD services. Specifically, the rate change impacts the following services:
• Ambulance
• Chiropractic
• Dental
• Durable Medical Equipment and Supplies, including Orthotics and Prosthetics
• Health Check
• Hearing Aids
• Home Health Agency
• Hospitals (non-Critical Access Hospitals)
• Mental Health and Substance Abuse
• Non-Emergency Transportation
• Nursing Services
• Occupational Therapy
• Personal Assistance Services
• Physical Therapy
• Physicians (excluding primary care codes)
• Podiatry
• Speech Pathology and Audiology
• Visual Care
The current and revised rate schedules are available online for public view at http://dhhs.ne.gov/medicaid/Pages/med_provhome.aspx. The schedules are also available for viewing at each local office of the Department of Health and Human Services.
Comments may be submitted to and reviewed by the public at the Department of Health and Human Services Legal Services, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-742-2382 or e-mail to DHHS.RulesandRegs@nebraska.gov.

 
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
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 proposed change to the reimbursement methodology for Medicaid residents of Indian Health Service (IHS) nursing facilities. This change will allow Nebraska’s current methodology to comply with federal requirements.
The same prospective Medicaid rate would be paid to IHS nursing facilities for Medicaid residents who are IHS eligible and those who are not IHS-eligible.
 
IHS providers may receive quarterly Special Funding payments, the Federal Financial Participation share of allowable costs exceeding the rates paid for the Direct Nursing, Support Services and Fixed Cost Components for all Medicaid residents. After desk audit and determination of allowable costs for a Report Period, this amount would be calculated by adding the following two figures:
      1) The allowable Medicaid Federal Financial Participation percentage for IHS-eligible Medicaid residents multiplied by   
      the difference between the allowable costs and the total amount paid for all IHS-eligible Medicaid residents, if greater
      than zero; and
      2) The allowable Medicaid Federal Financial Participation percentage for non-IHS-eligible Medicaid residents multiplied
      by the difference between the allowable costs and the total amount paid for all non-IHS eligible Medicaid residents, if
      greater than zero.
Based on current allowable Medicaid Federal Financial Participation percentages, IHS nursing facilities would receive 100 percent reimbursement for their allowable costs exceeding the prospective rates for Medicaid residents who were IHS-eligible and approximately 60 percent reimbursement for their allowable costs exceeding the prospective rates for Medicaid residents who were not IHS-eligible.
This change will not result in any savings or additional cost to the Nebraska Medicaid program and will be consistent with current Medicaid reimbursement methodologies for governmental nursing facilities. Regulations will be developed to implement this change and a public hearing will be held during the regulation review process. This change will be implemented after the effective date of the regulations.
Comments may be submitted to and reviewed by the public at the Department of Health and Human Services Legal Services, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Fax 402-742-2382 or e-mail to DHHS.RulesandRegs@nebraska.gov.