Nebraska Medicaid Program

Recent Web Updates

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Following are recent updates to the Medicaid Program Web Pages.  Click on the link to view.

Posted 05/12/08

• Provider Bulletin 08-13 1.) Elimination of Claims Attachment Requirements for Certain Codes.
  2.) Change of Coding Requirements for IUD Billing. Applicable Provider Handbooks updated.

Posted 05/09/08

• Provider Bulletin 08-16 Billing Instructions for Outpatient Hospital/Facility Reporting of National Drug Codes (NDCs).  Applicable Provider Handbooks updated.

• Provider Bulletin 08-15 Reimbursement for Wheelchairs Provided to Clients Residing in Nursing Facilities (Bulletin to Nursing Facilities).  Applicable Provider Handbooks updated.

• Provider Bulletin 08-14 Reimbursement for Wheelchairs Provided to Clients Residing in Nursing Facilities (Bulletin to DME Suppliers).  Applicable Provider Handbooks updated.

Posted 04/23/08

• Provider Bulletin 08-11 Changes in the Home Health Agency Prior Authorization Process.   Applicable Provider Handbooks updated.

Posted 04/22/08

• Request for Information - Medicaid Eligibility Verification System

Posted 04/11/08

• Provider Bulletin 08-10 Managed Care Rate Increase

• Provider Bulletin 07-29 Procedure Code Change for the Annual Assessment by Psychologists

Posted 04/08/08

(This Provider Bulletin was inadvertently omitted from Provider Bulletin page)

• Provider Bulletin 05-01 2005 revisions to Long Term Care Facility Turnaround/Add-on billing document (MC-4) Format and completion instructions

Posted 03/19/08

• Changes to 471 NAC 9-002.11A Home Health Removed contract services coordination for Katie Beckett program (471 NAC 9-002.11B).

• Changes to 471 NAC 13-002.05 Nursing Services Removed contract services coordination for Katie Beckett program.

Posted 03/18/08

• Provider Bulletin 08-09 MIPS Claims Must Include Only Services Actually Provided

• Medicaid Reform Expenditures - Added Aged and Disabled Expenditures by Diagnosis - SFY 2007

Posted 03/17/08

• Provider Bulletin 08-06 Tamper-Resistant Presciption Pads for the Nebraska Medicaid Pharmacy Program (Revised)

Posted 03/12/08

• Provider Bulletin 08-07 Fee Schedule Rate Changes for Oxygen Services

Posted 3/10/08

• Provider Handbook - Revised Medicaid Claim Adjustment and Refund Procedures

• Provider Bulletin 08-08 Fee Schedule Rate Changes for Radiology Services

Posted 02/29/08

• Provider Bulletin 08-05 Hospital Billing Instructions for Claims with Share of Cost

Posted 02/28/08

• Provider Bulletin 08-04 Pregnancy - Related Services for the Ineligible Mother of an Eligible Unborn Child

Posted 02/19/08

• Kids Connection - Updated income chart

Posted 01/31/08

• Electronic Data Interchange (EDI) - Update EDI Trading Partner listing.

• Provider Bulletin 08-03 National Drug Code (NDC) Requirements for Physician Administered Medication

Posted 01/18/08

• General Information - New Page

• Nebraska Medicaid Program General Information Report 2007 - Added

• Nebraska Medicaid Program General Information Report 2006 - Added

Posted 01/14/08

• Provider Bulletin 08-02 National Drug Code (NDC) Submission for Physician Administered Drugs in an Outpatient Facility

• Provider Bulletin 08-01 Medicaid Prior Authorization:  Enzyme-Replacement Therapy (ERT) for Lysosomal Storage Disorders

• Provider Bulletin 07-32 Third Party Liability - Biling Medicaid when the Primary Insurance is Equal to Greater than the Medicaid Allowable

Posted 01/10/08

• Children’s Mental Health and Substance Abuse Statewide Infrastructure Grant (SIG) – Added notice for next Steering Committee meeting.

Posted 01/08/08

• Medicaid Management Information System (MMIS) Replacement Project Updated contact information

Posted 01/04/08

• Kids Connection - Added SCHIP Annual Report to CMS 2007

Posted 01/03/08

• Provider Bulletin 07-30 Death Review Process

Posted 12/20/07

• Provider Bulletin 07-28 2008 Aged & Disabled Medicaid Waiver Assisted Living Rates

Posted 12/03/07

• Medicaid Reform - Added SCHIP Final Report 11-29-2007 and Medicaid Reform Council 11-15-2007 Meeting Powerpoint

Posted 11/16/07

• Pharmacy Services - Added Cough and Cold Covered Products

• Provider Bulletin 07-04 Medicaid Reimbursement for End Stage Renal Disease (ESRD) Laboratory Tests - Added attachments.

• Provider Bulletin (July 2007 Postcard) Nebraska Medicaid Fee Schedules.

• Provider Bulletin (February 12, 2007 Postcard) Revised CMS-1450 Claim Form (UB-04).

• Provider Bulletin (January 2, 2007 Postcard) Revised CMS-1500 Claim Form and Electronic Claim Attachment Control Number Form (Form MC-2).

• Claims Processing Frequently Asked Questions - Added new questions, updated responses, and new links to forms and instructions.

• Electronic Data Interchange (EDI) - Added link to EDI Trading Partner listing.

• EDI Frequently Asked Questions - Updated EDI Trading Partner listing.

• Medicaid In Public Schools (MIPS) Provider Handbook.

• Nursing Facility Provider Handbook - Removed 471-000-4, 471-000-223 and 471-000-226.

• Provider Handbook - Added publication statement and information about printed copies.

• Payment Error Rate Measurement – Added additional information about this current initiative.

Posted 11/02/07

• Pharmacy Provider Handbook

• Provider Information - Added links to Pharmacy Services and Recent Web Updates.

Posted 10/30/07

• Children’s Mental Health and Substance Abuse Statewide Infrastructure Grant (SIG) – Added notice for next Steering Committee meeting.

Additional Postings - October 2007

(This listing is provided to catch the reader up on all changes to the Medicaid Program pages since July 2007.)

• Durable Medical Equipment, Medical Supplies, Orthotics and Prosthetics Provider Handbook

• Medical Transportation Provider Handbook

• Personal Assistance Services Provider Handbook

• Personal Assistance Services Provided in Adult Daycare Setting Provider Handbook

• Provider Bulletin 05-16 FQHC Cost Report Procedures (Dated 7/27/05)

• Provider Bulletin 03-11 Use of National HCPCS/CPT Procedure Codes and Modifiers for EPSDT Encounters (Dated 9/15/03)

• Provider Bulletin “L” Code Billing for Medicaid (Podiatry) (Dated 2/2/99)

• Provider Enrollment - Added instructions on enrollment and clarified information on keeping your provider agreement current.

• Mental Health & Substance Abuse Provider Enrollment - Added forms for Supervising Practitioner Statement, Integrated Practice Agreement, and Treatment Aide I and II.

• Nebraska Medicaid Program Homepage - Added “Who is Covered?” and application forms.

Additional Postings - September 2007

(This listing is provided to catch the reader up on all changes to the Medicaid Program pages since July 2007.)

• Form MC-82-AD, "Adult Day Care Nursing/Aide Services Claim Form" for billing Private Duty Nursing or Personal Assistance Services in Adult Day Care Centers ( 471-000-75).

• Pharmacy Services - Added link to Provider Bulletins.

• Provider Information - Added links to Electronic Funds Transfer (Direct Deposit) and Telehealth.

Additional Postings - August 2007

(This listing is provided to catch the reader up on all changes to the Medicaid Program pages since July 2007.)

• Form MC-66, “Recipient Choice of Lock-In Provider Agreement and Instructions” ( 471-000-93).

• Changes to 471 NAC 27-000 Medical Transportation Services: Revised regulations for transportation services to include payment for transportation services provided by an individual, to be paid at the current state employees’ mileage rate, as allowed under state law.

• Changes to 471 NAC 10-000 Hospital Services: Revisions to Medicaid payments for inpatient hospital services: Discontinues use of the Market Basket Index for the peer group base payment amount and the direct medical education payment amount after August 31, 2007; Decreases both by 1.7 % effective September 1, 2007 through June 30, 2008; and Increases these amounts by 1.90% effective July 1, 2008. (471 NAC 10-010.03A, 10-010.03B4, 10 -010.03B6a, 10-010.03B11, 10-010.03D3, and 10-010.03E1).

• Changes to 471 NAC 3-000 Payment for Medical Services: Requires health plans and self-funded insurers to cooperate with the Department by responding to requests for information on coverage of a Medicaid-eligible individual. (471 NAC 3-004.12).

• Children’s Mental Health and Substance Abuse Statewide Infrastructure Grant (SIG) – Updated contact information.

Additional Postings - July 2007

(This listing is provided to catch the reader up on all changes to the Medicaid Program pages since July 2007.)

• Home Health Agency Services Fee Schedule Effective July 1, 2007 ( 471-000-509).

• RN/LPN Private Duty Nursing Services Fee Schedule Effective July 1, 2007 ( 471-000-513).

• Personal Assistance Services Rate Listing Effective July 1, 2007 ( 471-000-515).

• Completion Instructions for the 2006, 2002, 1999 and 1994 ADA Dental Claim Forms ( 471-000-88).

• Dental Services Fee Schedule Effective July 1, 2007 ( 471-000-506).

• Billing Instructions for Hospital Services ( 471-000-83, page 7 of 8, #69). The admitting diagnosis is required on all claims..

• Changes to 471 NAC 12-000 Nursing Facility Services: Clarifies existing regulations governing prorating therapeutic leave bedhold days (471 NAC 12-009.07); defines the Rate Period for Nursing Facilities (NFs) as July 1, 2007 through June 30, 2008, and rebases NF rates to 2006 costs (471 NAC 12-011.08A); Increases the fixed cost maximum for NFs reimbursed under the case mix system from $20 to $25 per day (471 NAC 12-011.08D and 471 NAC 12-011.08D3); Calculates NF payment rates for Fiscal Year 2008 using a 4.9% inflation factor (471 NAC 12-011.08D4); Changes the basis of payment to new NF providers from an average rate to the seller’s rate (471 NAC 12-011.08H); and Establishes a fixed cost maximum for NFs reimbursed under special needs contracting at $50 per day and removes the requirement that special needs contracts must be signed prior to payment (471 NAC 12-014.05A).

• Changes to 471 NAC 31-000 ICR/MR Services: Defines the Rate Period for ICF/MRs as July 1, 2007 through June 30, 2008 (471 NAC 31-008.06); Rebases ICF/MR rates to 2006 costs (471 NAC 31-008.06C); and Calculates ICF/MR payment rates for Fiscal Year 2008 using a 4.9% inflation factor (471 NAC 31-008.06C5).

Posted 10/26/07

• Provider Bulletin 07-25  Correction to Hospice Payment Rates and Wage Index

• Provider Bulletin 07-19 Change in Prior Authorization Process

• Provider Bulletin 07-17 Nebraska Medicaid RN/LPN Fee Schedule

• Provider Bulletin 07-16 Nebraska Medicaid Home Health Agency Fee Schedule

• Provider Bulletin 07-15 Personal Assistance Services Rate Increase July 1, 2007

• Provider Bulletin 07-13 Home Health Agency Prior Authorization Process Changes on June 5, 2007

• Provider Bulletin 07-02 Medicaid Dental Fee Schedule - CDT - 2007/2008

Posted 10/25/07

• Provider Bulletin 07-27 Cough and Cold Covered Products

Posted 10/12/07

• Provider Bulletin 07-26 2007/2008 Medicaid RSV Infection Prophlaxis Update

• Provider Bulletin 07-23 Peer Review Organization

Posted 10/05/07

• Hearing Aid Provider Handbook

• Mental Health and Substance Abuse Provider Handbook

• Provider Bulletin 07-24 Influenza Vaccine - 2007/2008 Update

Posted 10/1/07

• Dental Services Fee Schedule Effective July 1, 2007 (471-000-506)

Posted 9/24/07

• Ambulatory Surgical Center Provider Handbook

• Aged & Disabled Medicaid Waiver Assisted Living Facility Provider Handbook

• Chiropractic Provider Handbook

• Dental Provider Handbook

• Dialysis Center Provider Handbook

• Federally Qualified Health Center Provider Handbook

• Home Health Provider Handbook

• Hospice Provider Handbook

• Hospital Provider Handbook

• ICF/MR Provider Handbook

• Nursing Facility Provider Handbook

• Occupational Therapy Provider Handbook

• Physical Therapy Provider Handbook

• Physician/Laboratory Provider Handbook

• Podiatry Provider Handbook

• Private Duty Nursing Provider Handbook

• Rural Health Clinic Provider Handbook

• Speech Pathology and Audiology Provider Handbook

• Visual Care Provider Handbook

Posted 09/21/07

• Provider Bulletin Number 07-08  Ambulatory Surgery Center Rates:  January 1, 2007

Posted 09/19/07

• Physician Services Fee Schedule Effective July 1, 2007 ( 471-000-518)

Posted 09/14/07

• Provider Bulletin Number 07-21 Hospice Payment Rates and Wage Index

Posted 09/07/07

• Provider Bulletin Number 07-20 Tamper-Resistant Prescription Pads for the Nebraska Medicaid Pharmacy Program

• Durable Medical Equipment, Medical Supplies, Orthotics and Prosthetics Fee Schedule Effective July 1, 2007 ( 471-00-507)

Posted 8/10/07

• Provider Bulletin Number 07-14 Hospice Prior Authorization

Posted 7/25/07

• Visual Care Services Fee Schedule Effective July 1, 2007 ( 471-000-524)

Posted 7/24/07

• Mental Health and Substance Abuse Services Fee Schedule Effective July 1, 2007 ( 471-000-532)

Posted 7/19/07

• Ambulance Services Fee Schedule Effective July 1, 2007 ( 471-000-504)

• Chiropractic Services Fee Schedule Effective July 1, 2007 ( 471-000-505)

• HEALTH CHECK Services Fee Schedule Effective July 1, 2007 ( 471-000-533)

• Hearing Aid Fee Schedule Effective July 1, 2007 ( 471-000-508)

• Physical Therapy and Occupational Therapy Services Fee Schedule Effective July 1, 2007 ( 471-00-517)

• Podiatry Services Fee Schedule Effective July 1, 2007 ( 471-000-519)

• Speech Pathology and Audiology Services Fee Schedule Effective July 1, 2007 ( 471-000-523)

Posted 7/1/07

• Ambulance Provider Handbook

• Claims Processing Frequently Asked Questions

• Client Benefit Booklet

• Client Information

• Current Initiatives

• Deficit Reduction Act of 2005

• Electronic Data Interchange (EDI) Customer Support

• Electronic Funds Transfer (Direct Deposit) Frequently Asked Questions

• EDI Frequently Asked Questions

• EDI Testing

• EDI Trading Partner Reports

• Payment Error Rate Measurement (PERM)

• Provider Information

• Verifying Client Eligibility

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