Waiver Consulting Group — Start any program. In any state.

Nebraska - Assistive Technology Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

Nebraska’s Department of Health and Human Services (DHHS) authorizes Assistive Technology Services under Title 403 of the Nebraska Administrative Code for the Developmental Disabilities (DD) and Aged and Disabled (AD) waivers. Providers deliver equipment, commercial or customized devices, and participant training that increase functional capabilities and reduce reliance on paid staff.

Approval to bill for these services requires a direct provider referral from a state Resource Developer (RD) worker before an applicant can even create an account with Maximus, the state’s Medicaid enrollment broker. Agencies can enroll either as certified DD providers or as standard Medicaid vendors, provided they adhere to the Division of Medicaid and Long-Term Care (MLTC) Service Provider Agreement and maintain compliance with applicable manufacturing and installation standards.

1. Service Definition and Scope

Assistive Technology in Nebraska encompasses equipment, controls, or appliances that enable waiver participants to perform activities of daily living (ADLs) or communicate with their environment. Under Title 403 NAC 1-004.03, the service includes the provision, maintenance, and required participant training for these devices.

The service is designed to decrease the participant's need for assistance from others as a result of limitations due to disability, allowing them to reside safely in their own homes.

2. Regulatory and Oversight Agencies

The Nebraska Department of Health and Human Services (DHHS) oversees the administration of HCBS waivers, including the DD and AD waivers. Within DHHS, the Division of Medicaid and Long-Term Care (MLTC) sets the provider standards and manages the overarching Medicaid program.

Maximus operates as the state's contracted enrollment broker, handling the intake and screening of all HCBS provider applications on behalf of DHHS.

3. Gatekeeping Prerequisites: Who Can Even Apply

Nebraska does not utilize a Certificate of Need or closed RFP procurement for Assistive Technology vendors, but it strictly controls access to the enrollment portal. A prospective provider cannot independently initiate a Medicaid enrollment application for HCBS waiver services without prior state authorization.

The state uses a localized referral system to manage provider network entry, ensuring that only agencies or vendors actively needed by case managers are processed through the Maximus system.

4. Licensure and Certification Requirements

Nebraska does not issue a distinct "Assistive Technology License" through its public health division. Instead, providers are approved through Medicaid enrollment as either an Agency Provider or a Vendor under Title 403 NAC 1.

While a facility license is not required, providers must ensure that all equipment and installations comply with external regulatory standards, including local building codes.

5. Medicaid Provider Enrollment

HCBS provider enrollment is processed by Maximus on behalf of Nebraska DHHS. The process is entirely dependent on the initial RD worker referral and utilizes the state's designated enrollment portal.

Providers can submit their applications online or via paper, but the online portal is preferred for tracking background checks and credential reviews.

6. Staffing, Training and Background Checks

While vendors supplying equipment do not face the same intensive direct-care staffing ratios as residential providers, they must still meet baseline HCBS safety and training standards. Maximus reviews background checks during the enrollment phase.

Staff delivering and installing the technology must be competent not only in the equipment's mechanics but also in training waiver participants on its safe use.

7. Documentation, Policies and Records

Providers must maintain detailed records of the devices supplied, warranties, and participant training. Documentation must align with the state's web-based case management system requirements.

Because Assistive Technology cannot duplicate standard Medicaid benefits, providers must document that alternative funding sources were exhausted or inapplicable.

8. Billing, Rates and Claims

Assistive Technology is subject to strict participant budget caps under Title 403 NAC 1. Waiver claims in Nebraska are an exception to standard third-party liability rules, allowing providers to bill Medicaid directly while the state handles recovery.

Providers must ensure they do not balance bill waiver participants for denied claims unless the Medicaid payment was sent directly to the beneficiary.

9. Approval Sequence and Timeline

The approval sequence is linear and begins outside the enrollment portal. Providers must secure local authorization before Maximus will process their paperwork.

Because the process relies on coordination between the RD worker and Maximus, timelines depend heavily on the provider's responsiveness to background check requests and final activation steps.

10. Common Denials and Survey Findings

Applications and service authorizations are frequently delayed when providers fail to follow the strict referral sequence or attempt to bill for items covered by standard Medicaid.

Auditors also cite providers for failing to secure required warranties on expensive equipment or failing to document participant training.

11. Key Contacts and Resources

Prospective providers should utilize the official DHHS portals and Maximus resources to initiate the enrollment process and review current waiver service summaries.

The DHHS Provider Screening and Enrollment page is the primary hub for accessing the Maximus portal and reviewing HCBS enrollment flowcharts.

See all Nebraska services · Nebraska Medicaid consulting · book a consultation.