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Public Notice Regarding the Nebraska Sustainable Coverage Demonstration Application
On February 23, 2026, the Nebraska department of Health and Human Services (DHHS) posted a public notice of its intent to submit an application to CMS under Section 1115 of the Social Security Act. DHHS is seeking approval from CMS for a five-year demonstration called the Nebraska Sustainable Coverage waiver. Visit the Medicaid Public Notices webpage to view the full public notice.
The public comment period will be from February 23, 2026 to March 26, 2026. Comments pertaining to the public notice may be submitted to the Department of Health and Human Services Nebraska Medicaid, 301 Centennial Mall South, P.O. Box 95026, Lincoln, Nebraska 68509-5026. Comments may also be faxed to (402) 471-9092 or emailed to dhhs.demonstrationwaivers@nebraska.gov.
Program Update
Under the Section 1115 Sustainable Coverage Waiver, the State seeks to limit retroactive eligibility to the beginning of the month in which the individual applies for Medicaid. Via this waiver, Nebraska DHHS seeks to promote timely Medicaid enrollment and program sustainability. Individuals will be encouraged to apply for Medicaid immediately, whether or not they have an immediate need for care, which will promote continuity of coverage. Medicaid will align better with the commercial market, which does not have retroactive eligibility, making individuals more prepared should they transition to commercial coverage in the future. The change to retroactive eligibility will also encourage providers to work with individuals to complete Medicaid applications in a timely manner.
The Demonstration also seeks to promote program sustainability not only by limiting the start of coverage but also by promoting proactive healthcare management and efficient use of healthcare resources. Individuals with ongoing coverage are more able to maintain primary care and receive care in the most appropriate and efficient settings.
Importantly, the waiver does not seek to eliminate retroactive eligibility in its entirety. Individuals will remain eligible for coverage effective with the first day of the month of application. This will ensure that individuals do not face gaps in coverage due to potential delays in application processing.
The anticipated effective date for this waiver is October 1, 2026.
Program Information
Public Hearings
MLTC will hold public hearings to receive comments on the Section 1115 demonstration waiver application. The slides from the presentation are in the Program information section above.
- Wednesday, March 11, 2026 - 3:00pm-4:30pm
- Tuesday, March 17 - 11:00am-12:30 pm
- Legislative Hearing - Friday, February 27, 2026 - 1:30pm