Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services

What this rule requires your agency to do

• 1Providers are subject to Adult and Child Protective Services Central Registry checks; the Department will not enroll (and will immediately terminate) any provider with a substantiated or in-progress abuse/neglect report, and household members may be checked where service is provided at the provider's home (003.02(A)(xiii); 003.02(D)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 2Individual providers, and agency directors/administrators/legal signers/in-home service staff, must be age 19 or older; providers must have the knowledge, experience, and skills to perform patient care and EVV, and be able to recognize distress and access emergency resources (003.02(A)(xv),(xvi),(xix)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 3Providers must accurately document services in the EVV system and confirm services were received as authorized; Medicaid will not pay for services not performed during the actual hours noted in EVV, and providers may not serve more than one client at a time (003.02(H)(vii); 005.02(A)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 4Spouses and parents of minor children are not eligible to be providers, and providers may not be recipients of personal assistance or similar services (003.02(A)(iii),(xx); 004.03(B)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 5Providers of personal assistance services must comply with all applicable provider participation requirements in 471 NAC 1, 2, and 3 and follow Department policies in NAC 465, 471, 473, 474 and 480, billing only for services authorized and actually provided (003.01; 003.02(A)(i)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 6Providers must retain all enrollment, service, financial, and payment-support records for a minimum six-year retention period and allow federal/state/local audit and on-site inspection (003.02(A)(v),(vi),(H)(x)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 7The Department must send written notice of denial, reduction, or termination of services, mailed at least ten calendar days before the effective date (with stated exceptions), citing the action, reason, regulation, and appeal rights (006.03; 006.03(A)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)
• 8Personal assistance services must be prior authorized before provision, based on an assessment and service plan, for a period not exceeding one year, and are limited to a maximum of 40 hours per seven-day period unless the Department authorizes more (004.01(B)(iii)(1)-(3)).(Title 471 Nebraska Medical Assistance Program Services, Chapter 15 - Personal Assistance Services)