Bill
LB 486
The bill standardizes reimbursement for personal care providers under Nebraska’s Medicaid Aged and Disabled Waiver to a uniform rate based on a 2022 CBIZ Optumas study and rebases
LB486 — Summary
Overview
- Purpose: Require the Department of Health and Human Services (DHHS) to implement a standard reimbursement rate for personal care service providers under Nebraska’s Medicaid Aged and Disabled Personal Care Services Waiver, replacing individual rate negotiations. The standard rate must align with a rate study conducted for the state and must be rebased at least every two years.
- Status: Notice of hearing for February 27, 2025
- Introduced: January 21, 2025
- Committee/Sponsor: Health and Human Services; Principal Introducer Senator Dan Quick; Chair of the hearing is Senator Brian Hardin
What the bill would do
- Replace negotiated rates with a standardized reimbursement rate for personal care providers under the Aged and Disabled Personal Care Services Waiver.
- Establish that the standard rate must be consistent with a specific rate study provided to the State by CBIZ Optumas dated December 7, 2022.
- Require that the standard rate be rebased (updated) not less than every two years.
Key provisions
- Section 1: DHHS shall implement a standard reimbursement rate for service providers under the Aged and Disabled Personal Care Services Waiver.
- The rate must be consistent with the CBIZ Optumas rate study dated December 7, 2022.
- The rate must be rebased at least once every two years.
Affected parties and programs
- Service providers: Personal care providers currently reimbursed through individual negotiations will move to a single standardized rate.
- Recipients: Beneficiaries of the Medicaid Aged and Disabled Waiver who receive personal care services may experience changes in provider reimbursement structures.
- DHHS: Responsible for establishing and maintaining the standard rate and updating it on a biennial basis.
Implementation and timeline
- Legislative history: Introduced January 21, 2025; referred to the Health and Human Services Committee on January 23, 2025.
- Hearing: Notice of hearing scheduled for February 27, 2025.
- Rate study reference: CBIZ Optumas study dated December 7, 2022 serves as the basis for the standard rate.
Potential impacts and considerations
- Administrative: DHHS would assume responsibility for setting and updating the standard rate, moving away from provider-specific negotiations.
- Equity and consistency: A standardized rate aims to create uniform reimbursement for similar services in the same area.
- Provider considerations: Uniform rates may affect compensation levels for some providers; the biennial rebasing requirement creates a predictable update cycle.
- Fiscal implications: The bill could alter Medicaid waiver expenditures and budgeting, depending on how the standard rate compares to current negotiated rates.
Notes
- Source documents reference: Introduced as LB486 (2025), with a focus on the Aged and Disabled Waiver and a rate study by CBIZ Optumas (Dec. 7, 2022).
Compiled from official sources — confirm details with the bill’s official record.
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