Medicaid bill clears final round

Lawmakers passed a measure April 10 that makes a number of changes to state Medicaid provisions.

LB958, introduced by Sen. Machaela Cavanaugh of Omaha, requires that the assessment tool used by the state Department of Health and Human Services to determine functional eligibility, service needs and service tier assignments for Medicaid waiver participants be administered by an employee or contractor trained in clinical interviewing techniques.

Additionally, services authorized under a waiver must be based on individualized assessments of medical necessity, functional need and health and safety requirements as determined through a person-centered planning process in accordance with federal home and community based services waiver regulations.

The services must be sufficient in amount, duration and scope to reasonably serve the needs of participants and prevent unnecessary institutionalization, hospitalization or risk of serious harm. The measure also requires that determinations be communicated by DHHS to a waiver participant, or their parent or legal guardian, in a timely, clear and specific manner.

If an assessment results in a reduction of a waiver participant’s service tier, authorized service hours or service provision, the department is required to conduct an immediate supervisory review of the assessment and determination prior to final implementation of the reduction.

Additionally, DHHS must submit a report to the Legislative Oversight Committee, the Health and Human Services Committee and the Nebraska Office of Public Counsel regarding implementation and use of assessment tools for waiver participants no later than Aug. 1, and annual reports thereafter.

The bill also includes the amended provisions of three additional bills.

Cavanaugh’s LB777 requires DHHS to provide the maximum amount of retroactive coverage for each Medicaid eligibility category authorized by federal law under the One Big Beautiful Bill Act of 2025. It also requires the department to include information in the Medicaid and Long-Term Care annual report regarding work requirements, concurrent enrollment and cost sharing.

Provisions of Lincoln Sen. George Dungan’s LB773 expand the state’s Prenatal Plus Program to include a minimum of two breastfeeding support sessions, eliminate the program’s scheduled sunset date and extend reporting requirements to 2034.

Provisions of LB701, introduced by Sen. Ashlei Spivey of Omaha, require DHHS to reimburse Medicaid providers for trained doula services by Jan. 1, 2029, at rates determined by the department. The department will establish a group of stakeholders and experts to develop an implementation plan, to be submitted no later than Jan. 1, 2027.

LB958 passed on a 48-1 vote and takes effect immediately.