Upcoming Public Hearings on
Proposed DHHS Regulations

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All interested persons are invited to attend and comment at the hearing. Written comments are also welcome and will be given the same consideration as comments made in person. Written comments must be postmarked or received by the deadline indicated for each hearing. Written comments 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 will be available online 3 weeks before the hearing at http://www.sos.ne.gov/rules-and-regs/regtrack/index.cgi
 
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
Monday July 14, 2014 ​Early Intervention Service Coordination
Thursday July 17, 2014 ​Licensure of Genetic Counselors
Thursday August 21, 2014 ​Licensure of Funeral Directors, Embalmers, and Establishments
Public Notice ​SRY 15 Rates
Public Notice ​All-Patient Refined Diagnosis-Related Group notice
Public Notice ​Rate change notice
Public Notice DME Rate Method
Public Notice ​​Amended Indian Health Services Nursing Facility Medicaid Reimbursement Methodology

 

 
 Hearing
1:00 p.m. CT (12 noon - 1:00 PM MT)
Monday, July 14, 2014
Department of Education, State Board Room
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 regulations related to Early Intervention Services Coordination.  These regulations are found in Title 480 Chapter 3 of the Nebraska Administrative Code (NAC).  They will replace the current 480 NAC 10, which will be repealed.  The changes to the regulations will bring them into compliance with revised federal regulations under the Individuals with Disabilities Education Act (IDEA) Part C (20 U.S.C. 1431 through 1443 and 34 CFR Part 303).
 
In addition to the public hearing site in Lincoln, noted above, the hearing will be broadcast to the following video conference sites.  Interested persons may comment from:
 
 Omaha  ESU 3, Niobrara Room, 6949 South 110th
 Scottsbluff  Vocational Rehabilitation, 505A Broadway, Suite 500
 
Authority for these regulations is found in Neb. Rev. Stat. Sections 43-2501 to 43-2516 (the Early Intervention Act) and 81-3117(7).
 
Written comments must be postmarked or received by 5:00 p.m. CT on July 14, 2014.

 Hearing
Thursday, July 17, 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 new regulations related to the licensure of genetic counselors. These regulations are found in Title 172 Chapter 92 of the Nebraska Administrative Code (NAC). 
 
The proposed regulations will establish definitions, requirements for initial, provisional, and renewal licensure, including continuing competency, provisions for denied or withdrawn applications, unprofessional conduct, grounds for discipline, conditions for reinstatement of a license, and fees.
 
Authority for these regulations is found in the Genetic Counseling 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 July 17, 2014.

 Hearing
Thursday, August 21, 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 regulations related to the licensure of funeral directors and embalmers and the licensure of funeral establishments and branch establishments.  These regulations are found in Title 172, Chapters 67 and 68 of the Nebraska Administrative Code (NAC).  They will replace the current chapters 67 and 68, which will be repealed. 
 
This is a rewrite of these chapters to reflect the provisions of the Funeral Directing and Embalming Practice Act and the Uniform Credentialing Act.  Statutory language and procedural material have been removed from the proposed regulations. 
 
The regulations for the licensure of funeral directors and embalmers in chapter 67 contain:
• Non-statutory definitions;
• Qualifications for initial, reciprocity, and apprentice licenses;
• Examination requirements;
• Continuing education requirements for license renewal;
• Unprofessional conduct and grounds for discipline of a license; and
• Conditions for license reinstatement.
 
The regulations for the licensure of funeral establishments and branch establishments in chapter 68 contain:
• Non-statutory definitions;
• Qualifications for licensees;
• Establishment manager responsibilities;
• Requirements for amending and renewing a license;
• Standards for funeral services;
• Requirements for transportation and disposition of bodies;
• Inspection standards;
• Requirements for documentation, physical structure, equipment, and supplies;
• Grounds for discipline of a license; and
• Conditions for reapplication.
 
Authority for these regulations is found in the Funeral Directing and Embalming 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 August 21, 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 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 Nebraska Department of Health and Human Services Division of Medicaid and Long Term Care hereby provides notice of a proposed change in Medicaid hospital payment methodology.
 
Effective July 1, 2014, Nebraska Medicaid will implement the All-Patient Refined Diagnosis-Related Group (APR-DRG) Grouper to reimburse hospitals now paid under the DRG payment methodology.  Critical Access Hospitals and Indian Health Service facilities are not paid using the DRG payment methodology, and neither is expected to be impacted by this change.
 
The cost outlier threshold amount for neonate and nervous system APR-DRGs will be reduced to $30,000.  Hospital base rates will be adjusted uniformly to maintain budget neutrality.
 
Regulations to implement this change have been drafted and are scheduled for public hearing on December 26, 2013.  Draft regulations are available online from the Secretary of State at http://www.sos.state.ne.us/rules-and-regs/regtrack/index.cgi.

A State Plan Amendment will be submitted for approval by the Centers for Medicare and Medicaid Services (CMS).
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 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, 2013.   The rate increase is the result of an increase in appropriations by the Nebraska Legislature in LB 195 (2013).
The rate increase will exclude 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).   Medicaid will increase the rate for Critical Access Hospitals to 100% of the reasonable cost of providing Medicaid covered services.
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 $29,342,009 with $13,053,660 from General Funds and $16,288,349 from Federal match. 
The rate change is 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)
• ICF/MR services
• Mental Health and Substance Abuse
• Non-Emergency Transportation
• Nursing Facility
• 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_practitioner_fee_schedule.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 of Durable Medical Equipment and Supplies for Medicaid residents in Nursing Facilities (NF) and Intermediate Care Facilities and/or for persons with Mental Retardation and Related Conditions (ICF/MR). This change in policy will allow Nebraska’s reimbursement methodology to comply with federal requirements, 42 CFR 440.70.
 
DHHS will apply a per diem amount equal to the Medicaid day-weighted average calculated for nursing facilities and intermediate care facilities. The per diem add on will no longer be applied when the facility’s rate reflects the full cost of providing the medical equipment. Air fluidized beds, non-standard wheelchairs and wheelchair components, and negative pressure wound therapy (wound VAC) will be reimbursed separately to the facility according to the maximum allowable rate on the durable medical equipment and supplies fee schedule found at 471-000-507: http://dhhs.ne.gov/Documents/471-000-507.pdf.
 
This change will not result in any savings or additional cost to the Nebraska Medicaid program. 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.

 
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.