The purpose of this hearing is to receive comments on the proposed amendment and adoption of new regulations to Title 477 Chapters 3, 4, 5, 9, 10, 11, 19, 25, 26, 27, and 29 of the Nebraska Administrative Code (NAC) – Medicaid Eligibility.
The following regulations are proposed for AMENDMENT:
Title 477 NAC 3 – Application Process
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits. Additional changes include clarification on who can submit an application on an individual, allow medical providers to submit applications, and reflect continuous eligibility for hospitalized children.
Title 477 NAC 4 – Effective Date of Medicaid Eligibility
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, and updates to reflect the elimination of retroactive coverage requested through the 1115 demonstration application.
Title 477 NAC 5 – Citizenship/Alien Status and Identity
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, eliminates a duplicate reference, and removal extended Reasonable Opportunity as the Department does not take this option in the State Plan Amendment.
Title 477 NAC 9 – Notification
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, and includes notice requirements for individuals whose eligibility is suspended.
Title 477 NAC 10 – Fair Hearing Processes
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, and reflects changes in federal regulations allowing maintenance of serves pending appeal; if the request is made before the effective date of action.
Title 477 NAC 11 – Living Arrangements
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, living arrangement regulations have been consolidated into Chapter 11, and updates to policy related to individuals whose eligibility is suspended.
Title 477 NAC 19 – Modified Adjusted Gross Income (MAGI)-Based Programs
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, addition of the Heritage Health Adult group to the presumptive eligibility categories, and content was reorganized to consolidate information regarding presumptive eligibility.
Title 477 NAC 25 – Budgeting for the Medically Needy
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, the chapter was retitled, and content that was not relevant to the chapter subject title was removed.
Title 477 NAC 26 – Spousal Impoverishment Medicaid Program (SIMP)
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, and clarification added for community spouse Medicaid eligibility and treatment of trusts.
Title 477 NAC 27 – Eligibility for the Aged, Blind, and Disabled; Medically Needy; Qualified Disabled Working Individuals; Medicaid Insurance for the Workers with Disabilities; Breast and Cervical Cancer; Emergency Medical Services Assistance; and Katie Beckett
The proposed changes will provide the eligibility regulations for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, qualified disabled working individual was updated, and transitional medical assistance has been updated to clarify the rules for eligibility.
The following regulations are proposed for ADOPTION:
Title 477 NAC 29 – Heritage Health Adult Program
The adoption of these regulations will provide the eligibility for the new adult group required by Neb. Rev. Stat. § 68-992. This will include provisions to make this group eligible for Medicaid, as well as the regulations required to implement the 1115 waiver Nebraska is currently seeking from CMS for the implementation of expansion, including the basic and prime benefits, and implements the Heritage Health Adult Program. Phone call information: 888-820-1398; Participant code: 3213662#
Due to the current public health crisis, the agency will be enforcing the Centers for Disease Control’s recommendation on the size of gatherings. The public hearing will be limited to eight (8) in-person attendees. In order to encourage participation in this public hearing, a phone conference line will be set for any member of the public to call in and provide oral comments.
Interested persons may provide verbal comments by participating via phone conference line by calling 888-820-1398; Participant code: 3213662#
Interested persons may provide written comments by mail, fax, or email no later than the day of the hearing to: DHHS Legal Services, PO Box 95026, Lincoln, NE 68509-5026, (402) 742-2382 or dhhs.regulations@nebraska.gov, respectively. Any written comments will be part of the record and will be considered.