Lincoln, NE — On July 18, Nebraska Department of Health and Human Services (DHHS) CEO Steve Corsi, Medicaid and Long-Term Care Division Director Drew Gonshorowski, and Karoly Mirnics, dean and director of the Munroe-Meyer Institute provided information about the approaching adjustment to Medicaid payment rates for Applied Behavior Analysis (ABA) services to Nebraska families. Rate adjustments will go into effect Aug. 1.
Following months of communication with providers, it became evident that misinformation was being conveyed, including to the public. Those discussions focused on DHHS’ need to adjust payment rates to sustainable levels, commensurate with the rates of surrounding states.
During the news conference, CEO Corsi reiterated that rate modifications would not result in a lapse of care for clients or their families.
“I want to be exceedingly clear, DHHS is fully committed to continuing ABA services to Nebraska families receiving Medicaid,” said Corsi. “We will continue to operate in the best interest of children and families.”
Currently, Nebraska payment rates for ABA services are the highest of any in the nation. Rates have risen dramatically since 2023. Rate increases are enacted by the Legislature.
Per Code of Federal Regulations (CFR) 447.200, payments for services must be consistent with efficiency, economy, and quality of care. Medicaid rates are periodically reviewed for market comparison with respect to other relative payer sources, such as Medicare and other state Medicaid agencies.
DHHS completed a thorough review of Nebraska Medicaid rates for ABA services and observed that Nebraska’s rates for these services have been significantly higher, some more than twice as high as those of other state Medicaid programs.
In 2020, Nebraska Medicaid paid approximately $4.6 million for ABA Services. In 2024, Nebraska Medicaid paid approximately $85.6 million for ABA Services. This amounts to an approximate increase of 2,025%.
To make sure that these services are available and sustainable going forward, DHHS is adjusting its payment rates to better align with surrounding states. Even after factoring in the rate adjustments Nebraska Medicaid rates for ABA services compare favorably with neighboring states. Also of note, the commonly billed rates will remain higher than the national average and median.
“These changes came as a result of a rate analysis study conducted by Nebraska Medicaid that compared our state to surrounding Medicaid markets,” said Gonshorowski. “We found that Nebraska’s rates for these services have been significantly higher, some more than twice as high, as those of other state Medicaid programs. This rate change puts Nebraska more in line with ABA rates, not just in the region, but nationally.”
The Munroe-Meyer Institute is one of the biggest and oldest developmental disability centers in the world. The nonprofit organization, an academic unit of the University of Nebraska Medical Center (UNMC), has a 105-year history of caring for vulnerable populations. They provide approximately 120,000 clinical visits a year with approximately 60% of those providing services for individuals and families with Autism Spectrum Disorder (ASD).
Dean and director of Munroe-Meyer, Dr. Karoly Mirnics stated his support for ensuring that rates were managed at a level appropriate to the services provided. “We will continue working with DHHS as close partners to develop evidence-based guardrails to provide the most meaningful, most efficient ABA services for all individuals with autism. This will be done thoughtfully, based on scientific data. We greatly appreciate DHHS’s willingness to work with us and soliciting our expert input on this process.”
To review the provider bulletin with rate adjustments, please click here.
