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 hearings. Written comments must be postmarked or received by 5:00 p.m. CT the day of the hearing, and should be e-mailed to DHHS.Regulations@nebraska.gov, faxed to 402-742-2382, or sent to DHHS Legal Services, 301 Centennial Mall South, P.O. Box 95026, Lincoln, NE 68509-5026. Copies of written comments and names of persons submitting them will be available after the hearing from DHHS as above.
 
Draft regulations are found at http://www.sos.ne.gov. Draft regulations are also available at DHHS as above, phone 402-471-8223, and at the office of the Secretary of State, Regulations Division, State Capitol Room 1305, Lincoln, NE 68509, phone 402-471-2385.  Draft fiscal impact statements for these regulations are available at DHHS as above.
 
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
Friday January 22, 2016 ​Alcohol Content Analysis of Blood or Breath
Monday Febraury 1. 2016 ​SNAP Updates
Friday February 12, 2016 ​Child Care Development State Plan
Public Notice
(published 12/18/15)
​New Payment Methodology for FQHCs
Public Notice
(published 6/9/15 & 6/10/15)
​SFY16-RATES
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

 


Friday January 22, 2016
State Office Building, Lower Level F
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 Alcohol Content Analysis of Blood or Breath. These regulations are found in Title 177, Chapter 1 of the Nebraska Administrative Code (NAC).  The proposed changes will add Intoximeters, all models, to the list of approved methods for law enforcement to use to perform evidentiary breath testing.
 
Authority for these regulations is found in Neb. Rev. Stat. Sections 37-1254.05, 60-6,201, and 81-3117(7).
  
Written comments must be postmarked or received by 5:00 p.m. CT January 22, 2016.

Monday February 1, 2016
State Office Building, Lower Level A
301 Centennial Mall South, Lincoln, NE
 
The Department of Health and Human Services (DHHS) Division of Children and Family Services is holding this hearing to accept comments on proposed changes to regulations related to SNAP Updates. These regulations are found in Title 475, Chapters 1-5 of the Nebraska Administrative Code (NAC).  The proposed changes will impact regulated persons or entities by clarifying and simplifying application processing procedures, clarifying eligibility criteria, and harmonizing state and federal regulations.
 
Authority for these regulations is found in Neb. Rev. Stat. 81-3117(7).
 
Written comments must be postmarked or received by 5:00 p.m. CT February 1, 2016.

Friday February 12, 2016
State Office Building, Lower Level B
301 Centennial Mall South, Lincoln, NE
 
he Department of Health and Human Services is holding this hearing to accept comments on the proposed state plan for Child Care and Development for the period of June 1, 2016 to September 30, 2018.
 
The proposed plan is available from Nikki Suesz, CCDF Program Specialist, at Nikki.Suesz@nebraska.gov, 402-471-9347, or P.O. Box 95026, Lincoln, NE 68509. The proposed plan is also available at: http://dhhs.ne.gov/publichealth/Pages/chs_chc_chcindex.aspx
 
All interested persons are invited to attend and comment at the hearing or to submit comments in writing.  All comments should be submitted in writing by 5:00 p.m. CT on February 12, 2016 and sent to the following address:
 
State of NE Child Care
c/o CCDF Draft Plan Comments
PO Box 95026
Lincoln, NE 68509
 
If auxiliary aids or reasonable accommodations are needed to participate in the hearing, please call 402-471-8223.  For persons with hearing impairments, please call 402-471-9570 (voice and TDD) or the Nebraska Relay System at 711 or 800-833-7352 TDD.
 
Written comments must be postmarked or received by 5:00 p.m. CT February 12, 2016.

 
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 methodology change for Federally Qualified Health Centers (FQHCs).
 
The State of Nebraska currently reimburses FQHCs under the Prospective Payment System (PPS) rate methodology. Payment for FQHCs is guided by Section 1902(bb) of the Social Security Act, which defines parameters for a prospective payment system (PPS), and includes the option of an alternative payment methodology. FQHCs provide an essential primary care backbone for the Nebraska Medicaid delivery system. FQHCs serve low income and underserved populations, including but not limited to: migrant, homeless, and school based populations, and public housing residents. FQHCs provide a scope of services including: primary medical, dental, and behavioral health, case management and enabling services, such as interpretation. Services are provided on a discount fee schedule and no one is refused services based on inability to pay. Thus, the State of Nebraska intends to update the reimbursement methodology to reflect the federally approved Alternative Payment Methodology (APM) for FQHCs.
 
The State of Nebraska has elected to cover services for Nebraska eligible clients under the APM rate consistent with the PPS rate. Also similar to the PPS rate, the APM rate will exclude dental costs as FQHCs will continue to be reimbursed fee-for-service (FFS) for dental services outside of the APM rate. The implementation of the proposed payment methodology may result in an estimated increase in annual aggregate expenditures of $4.5 million dollars.
 
The effective date of the FQHC payment methodology change is January 1, 2016.
 
The current and revised rate schedules are available for public view 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.regulations@nebraska.gov

NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Notice

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 and an additional .25% increase for behavioral health, nursing facilities, assisted living and ICF-DD providers effective July 1, 2015. The rate increase is the result of an increase in appropriations by the Nebraska Legislature in LB657 (2015).
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 rate change will be reflected in the Nebraska Medicaid Practitioner Fee Schedules. 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 will be available online for public view at http://dhhs.ne.gov/medicaid/Pages/med_provhome.aspx. The schedules will also be 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.Regulations@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 (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.