Upcoming Public Hearings on
Proposed DHHS Regulations
 

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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 July 29. 2016 ​CHIROPRACTIC SERVICES (471)
Monday August 1. 2016 ​PODIATRY SERVICES (471)
Monday August 1. 2016 ​VISUAL CARE SERVICES (471)
Thursday August 4. 2016 ​LOW-INCOME HOME ENERGY PROGRAM AND COMMUNITY SERVICES BLOCK GRANT STATE PLAN
Monday August 8. 2016 REMOVE TERM 'HOMEBOUND' (471)

 


Friday July 29, 2016
State Office Building, Lower Level A
301 Centennial Mall South, Lincoln, NE
 
The purpose of this hearing is to receive comments on proposed changes to Nebraska Administrative Code Title 471, Nebraska Medicaid Program Services.  The Department of Health and Human Services (DHHS) recently completed a rewrite of several chapters of Title 471 – Nebraska Medical Assistance Program Services including 471 NAC 5.  These regulations govern the chiropractic services provided under Nebraska’s Medicaid Program.  The rewrite mainly consisted of identifying insufficient or inconsistent language, restructuring the regulatory chapters, and performing a compliance review to determine uniformity with State Plan, other NAC chapters, Federal law, and best practices. 
 
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 July 29, 2016  

 Monday August 1, 2016
State Office Building, Lower Level A
301 Centennial Mall South, Lincoln, NE
 
The purpose of this hearing is to receive comments on proposed changes to Nebraska Administrative Code Title 471, Nebraska Medicaid Program Services.  The Department of Health and Human Services (DHHS) recently completed a rewrite of several chapters of Title 471 – Nebraska Medical Assistance Program Services including 471 NAC 19.  These regulations govern the podiatry services provided under Nebraska’s Medicaid Program.  The rewrite mainly consisted of identifying insufficient or inconsistent language, restructuring the regulatory chapters, and performing a compliance review to determine uniformity with State Plan, other NAC chapters, Federal law, and best practices. 
  
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 August 1, 2016  

 Monday August 1, 2016
State Office Building, Lower Level A
301 Centennial Mall South, Lincoln, NE
 
The purpose of this hearing is to receive comments on proposed changes to Nebraska Administrative Code Title 471, Nebraska Medicaid Program Services.  The Department of Health and Human Services (DHHS) recently completed a rewrite of several chapters of Title 471 – Nebraska Medical Assistance Program Services including 471 NAC 24. These regulations govern the visual care services provided under Nebraska’s Medicaid Program.  The rewrite mainly consisted of identifying insufficient or inconsistent language, restructuring the regulatory chapters, and performing a compliance review to determine uniformity with State Plan, other NAC chapters, Federal law, and best practices. 
 
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 August 1, 2016   

 Thursday August 4, 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 state plan for:
 
• The Low-Income Home Energy Assistance Program for the period of October 1, 2016 through September 30, 2017.  The state plan is submitted annually to the federal Department of Health and Human Services, which provides funding to states to assist low-income individuals and families with home heating and cooling costs.  The plan describes Nebraska’s program, including eligibility requirements and benefit guidelines.  The proposed plan is available from Sandy Payne, LIHEAP Program Specialist, at Sandy.Payne@nebraska.gov, 402-471-9262, or P.O. Box 95026, Lincoln, NE 68509.
 
• The Community Services Block Grant (CSBG) for the period of October 1, 2016 through September 30, 2018.  The state plan is submitted biennially to the federal Department of Health and Human Services. The CSBG is an anti-poverty federal grant providing the base funding for Nebraska’s nine local Community Action Agencies, which operate programs and services to low-income families statewide.  The CSBG also provides discretionary dollars used to fund specific programs or initiatives.  The plan describes Nebraska’s use of CSBG funds, including eligible entities, the service delivery system, and developing or ongoing initiatives.  The proposed plan is available from Jennifer Dreibelbis, CSBG Program Specialist, at Jennifer.Dreibelbis@nebraska.gov, 402-471-9346, or P.O. Box 95026, Lincoln, NE 68509.
 
Written comments must be postmarked or received by 5:00 p.m. CT August 18, 2016   
Monday August 8, 2016
State Office Building, Lower Level A
301 Centennial Mall South, Lincoln, NE
 
The purpose of this hearing is to receive comments on proposed changes to Nebraska Administrative Code Title 471, Nebraska Medicaid Program Services.  The United States Department of Health and Human Services, Centers for Medicare and Medicaid Services advised Nebraska Medicaid that the term “Homebound” is not in compliance with the provisions of section 1902(a) of the Social Security Act with respect to the Home Health benefit.  As a result of this “homebound” requirement, certain Medicaid beneficiaries are not receiving the full benefit package required under section 1902 (a) (10) of the Act, which in subparagraph (d) provides for the inclusion of home health services in the standard Medicaid benefit package.  Nebraska Medicaid also uses the term “homebound” with respect to Private Duty Nurse services as described in 471 NAC Chapter 13.  The proposed changes will remove the term “homebound” and replace it with the following:  “Based on the client’s medical condition, Home Health services are medically necessary and appropriate services to be provided in the home.” By making the change and complying with 1902 (a) (10) of the Act, Nebraska Medicaid may continue to provide for the service to be available to its beneficiaries.
 
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 August 8, 2016  

  
Public Notices of Proposed
Medicaid Payment Rate Changes  
  
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Notice - NF APPROVED BY DD'S RECOVERED
 
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 special funding provision for governmental nursing facilities.
City and county-owned and operated nursing facilities will be eligible to receive 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 effective July 1, 2016.The reimbursement is subject to the payment limits of 42 CFR 447.272. 
Comments pertaining to the aforementioned may be submitted to 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.  Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
Posted: June 30, 2016

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 rates for new services covered under the Medicaid program: multisystemic therapy and functional family therapy. The estimated increase in annual aggregate expenditures by the benefit category or service being affected is as followed:
 
FFY16: $456,745 (FF $263,591, GF $193,154)
FFY17: $2,255,233 (FF $1,340,240, GF $914,994)
FFY18: $3,539,994 (FF $2,104,610, GF $1,435,382)
 
Multisystemic Therapy and Functional Family Therapy
Rates:
 
Multisystemic  Therapy
Modifier
Service
Rate
Procedure Code H2033
none
Per 15 minute increments
$38.28
 
Functional Family Therapy
 
Modifier
Service
Rate
Procedure Code 90832
U9
Psychotherapy 30 minutes
 
$63.91
Procedure Code 90834
U9
Psychotherapy 45 minutes
 
$95.87
Procedure Code 90837
U9
Psychotherapy 60 minutes
 
$127.82
Procedure Code 90846
 
 
U9
Family therapy without identified client present
 
$102.52
Procedure Code 90847
 
U9
Family therapy with identified client present
$106.10
 
Comments pertaining to the aforementioned may be submitted to 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.  Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
Posted:  June 30, 2016
Update July 12, 2016 (The only change from the original June 30, 2016 posting is the Procedure Code for “Family therapy with identified client present” changed from 90846 to 90847.)

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, 2016. The rate increase is the result of an increase in appropriations by the Nebraska Legislature in LB657 (2015). The estimated increase in annual aggregate expenditures by the benefit category or service being affected is as followed:
 
  ALL SERVICE TYPES
total GF FF
Inpatient Hospital $977,613 $477,466 $500,147
Physicians (excl primary care) $1,036,688 $506,318 $530,370
Dental $493,830 $241,186 $252,644
Capitated Svcs $12,888,478 $6,294,733 $6,593,745
Outpatient Hospital $1,052,306 $513,946 $538,360
Nursing Facility $7,280,720 $3,555,904 $3,724,816
Lab $24,749 $12,088 $12,661
Radiology $28,983 $14,156 $14,827
Home Health/PAS/Hospice $662,553 $323,591 $338,962
All Other $12,334,139 $6,023,993 $6,310,146
TOTAL $36,780,058 $17,963,380 $18,816,678
 
 
• 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 and fee schedules will be 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.Regulations@nebraska.gov.
Posted: June 30, 2016
 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 a special funding provision for governmental nursing facilities.
 
City and county-owned and operated nursing facilities will be eligible to receive 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 effective July 1, 2016.The reimbursement is subject to the payment limits of 42 CFR 447.272.  The estimated increase in annual aggregate federal expenditures for this benefit is $120,000.00
 
Comments pertaining to the aforementioned may be submitted to 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. Copies of this change are also available for viewing at each local office of the Department of Health and Human Services.
 
Posted: June 30, 2016 

 NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Notice - New Payment Methodology for FQHCs
 
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