471 Neb. Admin. Code, ch. 39, § 003

Current through June 17, 2024

Section 471-39-003 - BENEFIT PLAN AND SERVICES

003.01NEBRASKA ALTERNATIVE BENEFIT PLAN. The Nebraska Alternative Benefit Plan offers all services as described in the Title XIX Plan and listed in 471 NAC 1.

003.01(A)NEBRASKA ALTERNATIVE BENEFIT PLAN SERVICES.

For the purposes of the Nebraska Alternative Benefit Plan, these services are grouped as follows;

(i) Ambulatory patient services as set forth in 471 NAC 5, 9, 10, 18, 26, 36, and 34;

(ii) Emergency services as set forth in 471 NAC 4 and 10;

(iii) Hospitalization as set forth in 471 NAC 10;

(iv) Maternity and newborn care as set forth in 471 NAC 9, 10, 18, 26, 34, 36, and 42;

(v) Mental health and substance use disorder services as set forth in 471 NAC 9, 10, 18, 20, 26, 34, 35, and 36;

(vi) Prescription drugs/pharmacy as set forth in 471 NAC 16;

(vii) Rehabilitative and habilitative services and devices as set forth in 471 NAC 7, 9, 14, 21, and 23;

(viii) Laboratory services as set forth in 471 NAC 10;

(ix) Preventative and wellness services and chronic disease management as set forth in 471 NAC 10, 18, and 33;

(x) Early periodic screening, diagnosis, and treatment (EPSDT) as set forth in 471 NAC 33;

(xi) Other services as follows;

(1) Rural Health Clinic as set forth in 471 NAC 34;

(2) Federally Qualified Health Center (FQHC) as set forth in 471 NAC 29;

(3) Certified pediatric & family nurse practitioner services as set forth in 471 NAC 10;

(4) Podiatrists' services as set forth in 471 NAC 19;

(5) Case management as set forth in 477 NAC 4;

(6) Inpatient psychiatric services under age 21 as set forth in 471 NAC 20;

(7) Telehealth as set forth in Title 471 NAC;

(8) Non-emergency transportation as set forth in 471 NAC 27;

(9) Respiratory care services as set forth in 471 NAC 22;

(10) Abortion services as set forth in 471 NAC 10 and 18;

(11) Family planning services and supplies as set forth in 471 NAC 10 and 18;

(12) Critical care hospital as set forth in 471 NAC 10;

(13) Intermediate care facility services as set forth in 471 NAC 12;

(14) Program or All-Inclusive Care (PACE) services as set forth in 471 NAC 37;

(15) Long term nursing facility services as set forth in 471 NAC 12;

(16) 915 (C) Home and Community Based Services (HCBS) waivers as set forth in Title 480 NAC;

(17) Personal assistance services as set forth in 471 NAC 15;

(18) Private duty nursing services as set forth in 471 NAC 13;

(19) Medically-monitored inpatient withdraw management as set forth in 471 NAC 20;

(20) Opioid treatment program as set forth in 471 NAC 20;

(21) Dental services as set forth in 471 NAC 6;

(22) Dentures as set forth in 471 NAC 6;

(23) Optometrists' services as set forth in 471 NAC 24;

(24) Eyeglasses as set forth in 471 NAC 24; and

(25) Over-the-counter (OTC) pharmacy services as set forth in 471 NAC 16.

471 Neb. Admin. Code, ch. 39, § 003

Adopted effective 7/29/2020

Amended effective 9/27/2021