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Nebraska - Transitional Assistance Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Nebraska Department of Health and Human Services (DHHS) Division of Disability and Aging (DDA) funds one-time institutional discharge set-up costs through the Aged and Disabled (AD) and Traumatic Brain Injury (TBI) waivers. Providers of these transition services do not obtain a distinct facility license; instead, they must execute a Form MC-19 Nebraska Service Provider Agreement and enroll directly through the state's Maximus-managed Provider Screening and Enrollment portal.

Approval requires an active National Provider Identifier (NPI) and clearance through the Maximus screening process for Home and Community-Based Services (HCBS). Applicants must be selected by a participant's Service Coordinator and incorporated into an approved Person-Centered Plan before any authorized billing can occur.

1. Service Definition and Scope

In Nebraska, transition services cover one-time, non-recurring expenses necessary to establish a basic household when a Medicaid participant transitions from an institutional setting to a community-based residence. This includes security deposits, essential furnishings, utility set-up fees, and moving expenses.

The service is authorized under the AD Waiver and TBI Waiver to support the participant's Person-Centered Plan. It does not cover ongoing rent, food, or recreational items.

2. Regulatory and Oversight Agencies

The Nebraska Department of Health and Human Services (DHHS) oversees all HCBS waiver services. Within DHHS, the Division of Disability and Aging (DDA) manages the AD and TBI waivers and sets provider policy.

Provider enrollment and screening are contracted to Maximus, which operates the state's Medicaid enrollment portal and processes the MC-19 agreements.

3. Gatekeeping Prerequisites: Who Can Even Apply

Nebraska does not impose a Certificate of Need (CON), competitive procurement (RFP), or closed-network moratorium on HCBS transition service providers. Any entity or individual meeting the basic Medicaid screening criteria can submit an application.

However, providers cannot receive a retroactive start date for HCBS enrollment. Furthermore, a provider must secure a National Provider Identifier (NPI) before initiating the Maximus enrollment sequence.

4. Licensure and Certification Requirements

Nebraska does not issue a distinct Transitional Assistance Provider license. Because the service consists primarily of purchasing goods and coordinating logistics rather than providing direct medical or personal care, providers are exempt from standard health facility licensure under Title 175.

Instead, providers are certified through the Medicaid enrollment process itself, agreeing to abide by the AD and TBI Provider Policy Manual and the Nebraska Administrative Code (NAC) Title 473 and Title 480 regulations governing HCBS.

5. Medicaid Provider Enrollment

Enrollment is conducted entirely online via the Maximus web portal. Applicants must complete Form MC-19 (Nebraska Service Provider Agreement) and select the appropriate HCBS provider type and program codes.

Each physical location must be enrolled separately. The process requires submitting the MC-19, tax forms, and the MLTC-62 form, followed by Maximus's screening and final approval by the DHHS Provider Relations team.

6. Staffing, Training and Background Checks

Because transition services do not involve direct, ongoing physical care, the staffing requirements are administrative. Agency owners must ensure all employees have an NPI and use it for screening purposes.

All personnel involved in coordinating transition services must pass standard Medicaid background checks, including the Nebraska Adult and Child Abuse and Neglect Registries, and must not appear on the federal OIG List of Excluded Individuals/Entities (LEIE).

7. Documentation, Policies and Records

Providers must maintain records proving that all purchased items and deposits directly match the authorizations in the participant's Person-Centered Plan. Receipts, invoices, and lease agreements must be retained to substantiate every billed claim.

The AD and TBI Provider Policy Manual requires providers to keep these financial and service records for a minimum of five years and make them available for DHHS or CMS audits upon request.

8. Billing, Rates and Claims

Transitional assistance is reimbursed on a Fee-for-Service (FFS) basis. Providers bill Nebraska Medicaid for the exact cost of the approved items or deposits, up to the lifetime or waiver-specific cap established in the AD or TBI waiver.

Claims must include the specific HCBS procedure codes authorized by the Service Coordinator. Providers cannot bill for services or items prior to the participant's actual transition date or outside the scope of the Person-Centered Plan.

9. Approval Sequence and Timeline

The sequence begins with obtaining an NPI and registering the business entity. The provider then submits the MC-19 and supporting documents through the Maximus portal.

Maximus conducts the primary screening and background checks. Once cleared, DHHS Provider Relations issues the final approval, activating the provider's Medicaid ID. The entire process typically takes 30 to 60 days, provided all forms are accurate.

10. Common Denials and Survey Findings

Enrollment applications are most frequently rejected due to mismatched legal names between the IRS (W-9), the NPI registry, and the MC-19 form. Maximus will return applications if the physical address is listed as a P.O. Box.

During post-payment reviews, providers face recoupment if they bill for transition items not explicitly authorized in the Person-Centered Plan, or if they fail to produce original receipts for the purchased goods and deposits.

11. Key Contacts and Resources

Providers should direct enrollment questions to Maximus Customer Service and policy questions to the DHHS Division of Disability and Aging. The DHHS website hosts the AD and TBI Provider Policy Manual and fee schedules.

For claims and billing support, providers contact the DHHS ACCESSNebraska team or the specific Managed Care Organization if applicable, though HCBS waivers are primarily FFS.

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