Nebraska Medicaid Waivers & Home and Community Based Programs Overview

Nebraska, known as The Cornhusker State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC), and the Division of Developmental Disabilities (DDD), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings instead of institutional care.

Key waiver programs include the Aged and Disabled (AD) Waiver, which provides personal care, respite, and assistive technology for seniors and adults with physical disabilities, and the Comprehensive Developmental Disabilities (CDD) Waiver, which offers habilitation, employment support, and residential services for individuals with intellectual and developmental disabilities (IDD). Additional programs include the Traumatic Brain Injury (TBI) Waiver, the Katie Beckett Program (TEFRA Medicaid Option) for children with significant disabilities, and the Health Insurance Premium Payment (HIPP) Program, which helps eligible individuals maintain private insurance while receiving Medicaid benefits. Nebraska also offers Self-Direction options, allowing waiver participants to manage their care and hire their own caregivers.

Regulatory oversight in Nebraska is managed through DHHS, MLTC, and DDD, with additional provider licensing and compliance enforcement handled by the Division of Public Health (DPH), Licensure Unit. Nebraska operates under both fee-for-service and managed care models, with HCBS services coordinated through Heritage Health, the state’s Medicaid managed care program, which integrates physical, behavioral, and long-term care services. The state has also implemented Electronic Visit Verification (EVV) for personal care services, enhancing compliance and service integrity.

Providers must navigate Medicaid enrollment, waiver-specific service authorization requirements, and rigorous quality assurance measures to successfully participate in Nebraska’s HCBS system. With a strong emphasis on rural healthcare access, person-centered planning, and community integration, Nebraska’s Medicaid waiver programs ensure that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and full inclusion in their communities.

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Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

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