Medicaid managed care carve-out approved

Lawmakers passed a bill April 10 that changes the reimbursement structure for skilled nursing services provided to certain long-term care Medicaid recipients in Nebraska.

LB1091, introduced by Sen. Eliot Bostar of Lincoln, requires the state Department of Health and Human Services to provide a carve-out from Nebraska’s Medicaid managed care program for services and supports for long-term care clients with special needs.

The measure requires those services instead to be administered and reimbursed through a Medicaid fee-for-service or other delivery system authorized under state or federal law. It also prohibits a skilled nursing facility from being required to enroll in an MCO as a condition of eligibility to provide such services.

Under the bill, DHHS must amend Medicaid managed care contracts, including revisions to enrollment processes, no later than six months after the bill’s effective date.

LB1091 passed 49-0.