Bill > LB1091

This bill amends existing law to establish specific requirements for the Department of Health and Human Services regarding long-term care clients with special needs under the medical assistance program, also known as Medicaid. The bill clarifies that skilled nursing facility and nursing facility services for these individuals will not be included in the Medicaid managed care program, which is a system where healthcare providers are paid a set amount per person to manage their care. Instead, these specialized services will continue to be managed and paid for through a fee-for-service model or another non-risk-based system, ensuring continuity of care and specialized oversight for individuals with complex or intensive medical or nursing needs that go beyond typical nursing facility care. The bill defines a "long-term care client with special needs" as a Medicaid recipient with such complex needs and states that providers of these services will not be required to enroll with a managed care organization as a condition of serving these clients, though managed care organizations may still coordinate other benefits or provide wraparound services as long as they do not manage the financial risk or utilization of the specialized nursing facility services. The department is also directed to implement these changes without increasing state General Fund expenditures beyond what would have been spent if these services were part of the managed care program and must adopt necessary rules and amend contracts within six months of the bill's effective date.

Health and Social Services

https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=63278