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 November 20, 2014 Medicaid Clinical Lab, Injectable Meds Payment
Thursday November 20, 2014 ​Behavioral Health Services
Thursday November 20, 2014 ​Licensure of Radon Measurement and Mitigation Specialists and Businesses
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
9:00 a.m. CT
Thursday, November 20, 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 proposed changes to regulations related to Medicaid payment for clinical laboratory services and for injectable medications administered by a health care practitioner.  These regulations are found in Title 471 of the Nebraska Administrative Code (NAC), Chapters 18, 19, 24, and 33.  The proposed changes provide for the Medicaid rate increase for these services budgeted by the 2013 Legislature for the 2013-2015 biennium.
 
Authority for these regulations is found in the Nebraska 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 November 20, 2014  

Hearing
10:00 a.m. CT
Thursday, November 20, 2014
State Office Building, Lower Level Conf. Room A
301 Centennial Mall South, Lincoln, NE
 
The DHHS Division of Behavioral Health is holding this hearing to accept comments on proposed changes to regulations related to Behavioral Health Services. These regulations are found in Title 206 of the NAC, Chapters 2, 3, 6, and the attachment Adult Behavioral Health Service Definitions.  The proposed changes will:
  • Replace the term “substance abuse” with “substance use disorder”, per the new edition of the Diagnostic and Statistical Manual (DSM);
  • Add a definition and update references to the ASAM (American Society of Addiction Medicine) criteria;
  • Clarify the term “clinician” in regard to medication discontinuation;
  • Delete unnecessary language on housing assistance;
  • Add provisions for the existing informal dispute resolution process;
  • Revise staffing provisions for substance use disorder assessment;
  • Revise staffing ratios for Halfway House and Short-Term Residential;
  • Add Halfway House to provisions related to therapeutic leave days; and
  • Delete references to Medicaid and Long-Term Care.

Authority for these regulations is found in the Nebraska Behavioral Health Services Act and Neb. Rev. Stat. Section 81-3117(7).

Written comments must be postmarked or received by 5:00 p.m. CT on November 20, 2014 


Hearing
1:30 p.m. CT
Thursday, November 20, 2014
State Office Building, Lower Level Conf. Room A
301 Centennial Mall South, Lincoln, NE
 
The DHHS Division of Public Health is holding this hearing to accept comments on proposed changes to regulations related to the licensure of radon measurement and mitigation specialists and businesses.  These regulations are found in Title 180 NAC Chapter 11.  They will replace the current 180 NAC 11, which will be repealed.
This is a rewrite of the chapter to reflect the provisions of the Radiation Control Act and the Uniform Credentialing Act.  Statutory language and licensing process-related material have been removed from the proposed regulations.  Other proposed changes include:
  • Removing exemptions from licensure for county extension agents and other educational professionals;
  • Clarifying language in regard to operating requirements and supplemental documentation;
  • Replacing references to the National Environmental Health Association with the National Radon Proficiency Program;
  • Changing some installation requirements for mitigation systems; and
  • Adding who performed the electrical work to reporting requirements for mitigation businesses.
Authority for these regulations is found in the Radiation Control Act and Neb. Rev. Stat. Section 81-3117(7).
 
Written comments must be postmarked or received by 5:00 p.m. CT on November 20, 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.