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
​Thursday June 20, 2013 ​Medicaid Behavioral Health Managed Care
​Thursday June 20, 2013 Medicaid Transfer on Death Deed Revocation
​Public Notice DME Rate Method
​Public Notice ​​Amended Indian Health Services Nursing Facility Medicaid Reimbursement Methodology
​Public Notice ​Rate Increase Notice

 

 
Hearing
Thursday, June 20, 2013
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 Behavioral Health Managed Care.  These regulations are found in Title 482, Chapters 1, 2, and 5 of the Nebraska Administrative Code (NAC).   The changes are intended to bring Nebraska into compliance with federal Centers for Medicare and Medicaid Services (CMS) requirements by establishing managed care statewide for Medicaid behavioral health clients.  The proposed regulations will:
 
• Provide for client participation and enrollment in both physical and behavioral health managed care;
• Update the behavioral health benefits package;
• Update terminology, eliminate duplication, and clarify language; and
• Make changes to reflect current Medicaid policy.
 
Authority for these regulations is found in Neb. Rev. Stat. Sections 68-901 to 68-974 (the Medical Assistance Act) and 81-3117(7) and Section 1932 of the Social Security Act.
 
Written comments must be postmarked or received by 5:00 p.m. CT on June 20, 2013.
 
 
Hearing
Thursday, June 20, 2013
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 determining the ownership of real estate as part of the determination of eligibility for an AABD grant (Aid to the Aged, Blind, or Disabled) and/or Medicaid.  These regulations are found in Title 469 Chapter 2 of the NAC.  The regulations provide that transfer on death deeds must be revoked for initial or continuing Medicaid eligibility, as authorized by Legislative Bill 536, Section 21 (2012).  Revocation will allow a surviving Medicaid spouse to receive his/her full share of the deceased spouse’s estate.
 
Authority for these regulations is found in Neb. Rev. Stat. Sections 68-901 to 68-974, 68-1001.01, 76-3421, and 81-3117(7).
 
Written comments must be postmarked or received by 5:00 p.m. CT on June 20, 2013.    
 
  
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.
 
 
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
 
This notice is given in compliance with 42 CFR 447.205.  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 1.5 percent provider rate increase effective July 1, 2012.    The 1.5 percent rate increase is applied to those services that experienced a 2.5 percent rate decrease in State Fiscal Year 2012.  The rate increase will exclude primary care procedure codes, ICF/MR services and Psychiatric Residential Treatment Facilities (PRTF), Indian Health Services (IHS), and transportation procedure codes. 
This rate increase is the result of an increase of appropriations by the Nebraska Legislature in LB 968 (2012).
The total increased expenditures as a result of a 1.5 percent rate increase to the Children’s Health Insurance (CHIP) and Medicaid Programs is $22,132,567 with $9,660,143 from General Funds and $12,472,424 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
• Injectables
• Mental Health and Substance Abuse
• 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.