Panel Of Lawmakers Discuss Medicaid Reimbursements

By Gordon HopkinsA panel of Nebraska lawmakers met at the State Capitol on Friday, September 5, to hear testimony about cuts to Medicaid reimbursements, specifically those focused on behavioral health and autism.While the meeting was open to the public, only those invited to speak were allowed to testify. On August 1 of this year, Nebraska Department of Health and Human Services (DHHS) implemented new reimbursement rates with reduce payments for applied behavior analysis (ABA) services.“DHHS recently completed a thorough review of Nebraska Medicaid rates for ABA services and observed that Nebraska’s rates are significantly higher than all 49 other states. In fact, ABA rates in Nebraska are more than double the national average,” DHHS noted in a statement. “As a result of the review, beginning August 1, DHHS will adjust ABA payment rates to align more closely with those of neighboring states. After these adjustments, rates remain competitive with surrounding states and continue to remain above the national average.” These cuts come as much of rural America, including Nebraska, is having to increase pay to bring health care providers to underserved areas.The first testifier was Matthew Ahern, the Deputy Director for the Division of Medicaid and Long-Term Care at DHHS. Ahern said, “Between 2020 and 2024, Medicaid payments for APA services in Nebraska increased from 4.6 million to 85.6 million, an increase of nearly 1,800 percent. This was due to a combination of factors, but primarily driven by a flood of providers entering the market to take advantage of relaxed telehealth requirements through the pandemic and Nebraska Medicaid’s ABA rates, which are among the highest in the country.” It is worth noting that on October 1, 2020 was the year Medicaid expansion took place, meaning the number of individuals eligible for Medicaid dramatically increased. According to Nebraska Appleseed, a nonprofit advocacy organization, more than 90,000 Nebraskans became eligible on that day.According to Mariel Fernandez of the Council of Autism Service Providers, the changes are already having a negative impact. She told lawmakers at the meeting, “These are preliminary results. They are not final because we have had not had enough time to collect the data. But thus far, 135 children and families have experienced an interruption to service since August 1st, with 90 percent of those impacted having Medicaid.”

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