Tag: Nebraska

Alternative Headline: Nebraska Cuts ABA Medicaid Rates

[MM Curator Summary]: Nebraska is lowering its Medicaid ABA reimbursement rates after costs surged over 2,000% in four years.

========================================

Nebraska Department of Health and Human Services (DHHS) CEO Steve Corsi, Medicaid and Long-Term Care Division Director Drew Gonshorowski, and Karoly Mirnics, dean and director of the Munroe-Meyer Institute provided information about the approaching adjustment to Medicaid payment rates for Applied Behavior Analysis (ABA) services to Nebraska families. Rate adjustments will go into effect Aug. 1.

Following months of communication with providers, it became evident that misinformation was being conveyed, including to the public. Those discussions focused on DHHS’ need to adjust payment rates to sustainable levels, commensurate with the rates of surrounding states.

At today’s news conference, CEO Corsi reiterated that rate modifications would not result in a lapse of care for clients or their families.

“I want to be exceedingly clear, DHHS is fully committed to continuing ABA services to Nebraska families receiving Medicaid,” said Corsi. “We will continue to operate in the best interest of children and families.”

Currently, Nebraska payment rates for ABA services are the highest of any in the nation. The graph below illustrates Nebraska’s expenditure to providers in comparison with other states. Rates have risen dramatically since 2023. Rate increases are enacted by the Legislature.

Per Code of Federal Regulations (CFR) 447.200, payments for services must be consistent with efficiency, economy, and quality of care. Medicaid rates are periodically reviewed for market comparison with respect to other relative payer sources, such as Medicare and other state Medicaid agencies.

DHHS completed a thorough review of Nebraska Medicaid rates for ABA services and observed that Nebraska’s rates for these services have been significantly higher, some more than twice as high as those of other state Medicaid programs.

In 2020, Nebraska Medicaid paid approximately $4.6 million for ABA Services. In 2024, Nebraska Medicaid paid approximately $85.6 million for ABA Services. This amounts to an approximate increase of 2,025%. 

To make sure that these services are available and sustainable going forward, DHHS is adjusting its payment rates to better align with surrounding states. Even after factoring in the rate adjustments Nebraska Medicaid rates for ABA services compare favorably with neighboring states. Also of note, the commonly billed rates will remain higher than the national average and median.

“These changes came as a result of a rate analysis study conducted by Nebraska Medicaid that compared our state to surrounding Medicaid markets,” said Gonshorowski. “We found that Nebraska’s rates for these services have been significantly higher, some more than twice as high, as those of other state Medicaid programs. This rate change puts Nebraska more in line with ABA rates, not just in the region, but nationally.”

The Munroe-Meyer Institute is one of the biggest and oldest developmental disability centers in the world. The nonprofit organization, an academic unit of the University of Nebraska Medical Center (UNMC), has a 105-year history of caring for vulnerable populations. They provide approximately 120,000 clinical visits a year with approximately 60% of those providing services for individuals and families with Autism Spectrum Disorder (ASD).

Dean and director of Munroe-Meyer, Dr. Karoly Mirnics stated his support for ensuring that rates were managed at a level appropriate to the services provided. “We will continue working with DHHS as close partners to develop evidence-based guardrails to provide the most meaningful, most efficient ABA services for all individuals with autism. This will be done thoughtfully, based on scientific data. We greatly appreciate DHHS’s willingness to work with us and soliciting our expert input on this process.”

To review the provider bulletin with rate adjustments, please click here.

https://chadronradio.com/dhhs-explains-medicaid-rate-adjustment-in-response-to-provider-misinformation/

COLOR CODE: 

General item, but important. Gets at main point of article= YELLOW

Has a dollar amount or number = GREEN

A specific topic that seems to be different than other topics = BLUE

Alternative Headline: Families Brace for Medicaid Cuts

[MM Curator Summary]: Anticipating future Medicaid cuts, Nebraska families are already preparing for care disruptions under the Big Beautiful Bill.

==============================

OMAHA, Neb. (WOWT) – Cuts to Medicaid-funded services have many feeling on edge. While some of the impacts of the “Big Beautiful Bill” won’t take effect until 2027, a resident in Weeping Water is already preparing for the worst.

In May, First Alert 6 spoke with Colleen Rothe-Groleau and her older brother, Scott. At the time, she was concerned that proposed cuts to Medicaid would impact Scott’s care.

“Finally, somebody said, ‘What’s the reason that these seizures are coming so fast and they’re getting so bad?” Rothe-Groleau said.

Childhood health problems left Scott multi-handicapped. Colleen is Scott’s guardian, but he lives in an Omaha group home full-time.

A little over a month later, the bill passes, adding more uncertainty to the future of the services he relies on.

“I don’t know exactly where all the monies comes from,” said Colleen. “I do not know how much comes from donors, how much money comes from the federal government, how much money comes from Medicaid, Medicare, I do not know where all the finances are.”

Cuts to healthcare services are something many organizations are keeping tabs on. Experts with the Nebraska Association of Service Providers say its important to start gathering medical documents.

“Get all of that handy or at least know the names of the clinicians and their contact information,” said Executive Director Alana Schriver. “Make sure DHHS and Social Security both have correct address for you, correct phone numbers for you, maybe even a backup phone number or address just to be on the safe side.”

With questions still lingering, Colleen is acting now. Spending thousands to prepare her home to begin caring for Scott, if his services are eliminated. “We have a ramp already built; we need to finish it. We have a bathroom that we are remodeling; we need to finish it,” said Colleen. “There are a number of structural issues that we are trying to keep in place just to prepare.”

If the worst happens, Colleen says she will have to care for Scott full time; which would be challenging. “We already have a house full of people; we already have residents in the house who are disabled,” said Colleen. “My husband is a disabled first responder, there is no way he can be a sole caretaker for my brother. I would have to either work remotely or stop work all together.”

For now, Colleen says she will continue efforts to bring her concerns to state and local lawmakers. Not backing down from the fight to get people like Scott, the care they deserve. She is also keeping an eye on if her husband could lose his coverage under Medicaid, as new work requirements take effect in a few years.

https://www.wowt.com/2025/07/11/nebraska-caregiver-preparing-future-cuts-medicaid/

COLOR CODE: 

General item, but important. Gets at main point of article= YELLOW

Has a dollar amount or number = GREEN

A specific topic that seems to be different than other topics = BLUE