Providers of Medicaid HCBS Waiver Services

​DDD has received approval from the Center for Medicare and Medicaid Services (CMS) for the additive Appendix K payments for all HCBS Waivers. Appendix K documents and approval letter are on the Regs & Waivers page.

Slides and Videos from presentations specific to AD and DD Providers are located below in the appropriate provider section. 

Appendices include a 15% increase to provider rates for most waiver services and a $20/day increase for the waiver service Assisted Living (in the AD Waiver) for services provided between January 1, 2022 and June 30, 2022. The following services in all waivers are exempt from the increased payments:

• Home and Vehicle Modification;
  
• Assisted Technology;
  
• PERS (Personal Emergency Services Response Systems); and
• Transportation.  
  

The $20/day increase on Assisted Living Facility services for AD Waiver providers will be paid as a retroactive payment for services between January 1, 2022 and March 21, 2022. These payments will begin processing by April 1, 2022. All services provided after March 21, 2022 will be processed with the increase factored into the Assisted Living service rate. 

The 15% increase on services will be issued to providers through two payments covering claims submitted during two service windows. The first window will cover claims submitted for services provided between January 1, 2022 and April 30, 2022, with the second window covering services provided between May 1, 2022 and June 30, 2022. 

The below table contains important deadlines for when claims need to be submitted and when payments will be remitted. The payment processing date is when the first payments will be processed from DDD, not when checks/direct deposits will be received. It will take additional time for our accounting teams to enter single vendor claims and issue payments.

If you have specific questions, send to: dhhs.ddproviderrelations@nebraska.gov.

The Federal 21st Century Cures Act includes a Medicaid requirement for Electronic Visit Verification (EVV). EVV allows in-home care providers to check in and out electronically. 

• Electronic Visit Verification - Main Medicaid page for EVV.
  
• Therap Electronic Visit Verification - EVV page specific to EVV with Therap.
  

• ​Nebraska Home and Community-Based Waiver Notification of Death Form - Form to report death of participant, in addition to incident reports. This is used for participants of any HCBS waiver.
  
• AD and TBI Incident Review Process  - Instructions for reporting incidents, including deaths, for participants of these waivers.
  
• Instructions for DD incident processes are in Therap section below.
  
• Physical Exam Form - May be used for a participant's annual exam.
• Request for Fair Hearing - File an appeal when you do not agree with a decision about provider enrollment or payment made by DDD.
  

​Nebraska Medicaid's spending plan for the additional funds available for home and community-based services (HCBS) through the American Rescue Plan Act received conditional approval from the federal government on January 31, 2022. 

Medicaid's most recent quarterly update to CMS is below:

• Quarterly Spending Plan Update (April 15, 2022)
  

Below are previous spending plan updates and correspondence from the federal government:

• FFY 2022 - Q3 Spending Plan Approval (From CMS, May 2, 2022) 
• HCBS Spending Plan - Conditional Approval (From CMS, January 31, 2022)
  
• Quarterly Spending Plan Update (January 31, 2022)
  

• Nebraska Medicaid Quarterly Spending Plan Update (October 15, 2021)
• HCBS Spending Plan - Partial Approval (From CMS, September 30, 2021)
• Nebraska HCBS Spending Plan (July 12, 2021)
  

​HCBS providers are required to complete incident reports and follow-up on Therap. Instructions are available:

• Incident Reporting and GER Guide in Therap 
  
• Incident Follow-up Guide  
  

​DDD is partnering with Liberty Healthcare, an independent quality improvement company. Liberty Healthcare is working with DDD to review operations and make recommendations for improvements to its systems and practices. For more information on mortality review:

• Liberty Bulletin for Mortality Review
  
• Nebraska Home and Community-Based Waiver Notification of Death Form
  

DD Providers

When a DD provider opens a new residential service setting, the provider must complete a self-assessment at least 15 business days before opening. Residential settings include group homes, host homes, and shared living homes. 

When a DD provider opens a new non-residential site, the provider must notify DDD Provider Relations at DHHS.DDProviderRelations@nebraska.gov so an assessment can be completed at least 15 business days before opening. Non-residential settings include workshops, hubs, enclaves, and other locations where day services occur.

AD and TBI Providers

AD and TBI Providers will have an assessment completed by their Resource Development worker when then enroll as a new provider and during their annual review. AD and TBI Providers may complete the heightened scrutiny worksheet as requested by DDD.

For more information on the plan for home and community-based services, visit the State Transition Plan page.

Therap is used for many things, including incident reports, billing, referrals and secure communication. 

• Therap Log In - The portal to enter your Therap account.
  
• Therap Training Academy - Sign up for free! Anyone can view and attend the offered trainings. Therap keeps track of your courses.