HCBS News 2026Jan09
Nebraska Medicaid Provider Manual
The Division of Medicaid and Long-Term Care (MLTC) published the Nebraska Medicaid Provider Manual on January 6, 2026. The manual outlines Nebraska Medicaid's coverage policy as well as the requirements and procedures for health care providers participating in Nebraska Medicaid. The Manual can be found here. Here are the highlights from this updated manual:
- Provider enrollment requirements have been updated.
- All providers must have an NPI number with distinction being made between individuals and agencies.
- Those owning 5% of more of a company must comply with criminal background checks including fingerprinting.
- Provider agreements (MC-19) must be revalidated every 5 years. HCBS providers much update their MC-190 every year.
- Provider screening is based on their assigned risk level- Limited, Moderate, or High. The document does not clarify which provider types belong to which category. We are seeking clarification on this.
- All providers are required to complete database checks including SAM, OIG, and Nebraska Exclusions list. Providers enrolled with the Nebraska Medicaid program are responsible for screening their staff based on the services they provide and the assigned risk level. These checks are required at least monthly and providers should have documentation they have checked all staff.
- Driver’s License checks who provide transportation to beneficiaries must follow the minimum driver's standards. This includes being at least nineteen years of age, operator’s permit, knowledge of rules of the road and no more than three (3) points assigned against their driver’s license, among other rules.
- Renewals and annual screenings are required for HCBS providers.
- The Program Integrity unit will investigate cased of fraud, waste, and abuse.
- Records for Medicaid provided services must be maintained for a minimum of six (6) years. Providers are required to report lost or damaged records.
Proposed Changes to A&D and TBI Waivers:
LeadingAge Nebraska has submitted comment regarding the proposed changes to the A&D and TBI waivers to DHHS. According to the DDD Public Comment site comments received prior to January 5, 2026, will be considered. You can view the comments made by LeadingAge Nebraska here. The proposed changes are intended to be implemented in July 2026. It is our sincere hope that DHHS will reconsider detrimental aspects being proposed. If substantial changes are made to the proposal, it will again be sent out for public comment.
