U.S. government OKs Nebraska's Medicaid waivers for developmental disabilities services

Courtney Miller, director of the state developmental disabilities division, said Wednesday that federal officials approved both of the state’s Medicaid waiver applications.

The approvals mean that federal Medicaid dollars will continue flowing to Nebraska to help pay for community-based services for developmentally disabled people.

The approvals also mean that providers whose payments for some services were cut in half last year will now get full funding for that care.

“We’ve identified and overcome many challenges together to design a better delivery system for those we serve,” Miller said.

Medicaid waivers allow states to bypass ordinary Medicaid regulations to better serve specific groups, in this case, people with developmental disabilities.

Nebraska’s developmental disability waivers pay for community-based services for people who might otherwise need to be in an institution.

Miller said the state got word earlier this month that the federal Centers for Medicare and Medicaid Services had approved the five-year renewal of Nebraska’s adult day services waiver.

CMS also approved a separate state request to combine the adult and children’s comprehensive waivers into one covering residential and day services throughout life.

The combined waiver will relieve stress on parents, who have had to worry about their children being able to transition from one to another, Miller said.

Federal approval also means an increase in the amount to be paid to providers of residential services that also provide day services.

Residential services include group homes, extended family homes and other types of living arrangements.

State officials negotiated the increase after discovering a billing problem that put Nebraska out of compliance with federal regulations.

The problem concerned payments for day services done by residential services providers that exceeded the limit of 35 hours per person per week.

When the problem was discovered, the state was no longer able to get federal Medicaid funding for those disputed hours. In response, the state reduced payment rates for those services.

Medicaid is a state-run program that uses a combination of state and federal dollars. It provides health care for low-income children, parents, the elderly and the disabled.

Part of the difficulty of getting the waiver applications approved was getting in compliance with the federal regulations, Miller said.

She said the state had to make changes in how services were broken out for billing purposes, while offering continuity for people being served.

Miller said state officials are continuing to work with federal officials on a plan for reviewing some $32 million worth of previously paid claims that may be affected by the billing problem. The review will determine which of those claims need to be repaid to the federal government.

martha.stoddard@owh.com, 402-473-9583