Section 471-18-003 - PROVIDER REQUIREMENTS003.01GENERAL PROVIDER REQUIREMENTS. To participate in Nebraska Medicaid, providers of physician services must comply with all applicable provider participation requirements codified in 471 Nebraska Administrative Code (NAC) 2 and 3. In the event provider participation requirements in 471 NAC 2 or 3 conflict with requirements outlined in this 471 NAC 18, the individual provider participation requirements in 471 NAC 18 will govern.003.02SPECIFIC PROVIDER REQUIREMENTS.003.02(A)INDEPENDENT CLINICAL LABORATORIES. An independent clinical laboratory must have a separate provider agreement with the Department. In addition to the provider agreement, independent clinical laboratories must meet the following requirements: (i) When state or applicable local law requires licensing of independent clinical laboratories, the laboratory must be licensed under the law; and(ii) The laboratory must meet the health or safety requirements of the United States Secretary of Health and Human Services.003.02(B)PROVIDERS OF PORTABLE X-RAY SERVICES. To be approved as a Nebraska Medicaid provider, providers of portable x-ray services must be certified by the Centers for Medicare and Medicaid Services (CMS) Regional Office. Each provider must submit to the Department a copy of Form CMS-1539, Medicare and Medicaid Certification and Transmittal, and remain in compliance with 42 CFR 486.100 through 486.110. An out-of-state portable x-ray provider must provide the Department with verification of certification from the Centers for Medicare and Medicaid Services (CMS) Regional Office. The Department approves or denies enrollment as a Nebraska Medicaid provider based on the certification information received from the Centers for Medicare and Medicaid Services (CMS) Regional Office. 003.02(B)(i)APPLICABILITY OF HEALTH AND SAFETY STANDARDS. Providers of portable x-ray services, except physicians who provide immediate personal supervision during the administration of diagnostic x-ray services, must comply with all health and safety standards in NAC Title 180.003.02(C)PROVIDERS OF NURSE MIDWIFE SERVICES. The nurse midwife is approved for enrollment in Medicaid under a group provider agreement with the physician with whom they have a practice agreement.003.02(D)PROVIDERS OF NURSE PRACTITIONER SERVICES. A nurse practitioner may provide services within the specialty areas in which they hold certification. They must be enrolled in accordance with the Provider Agreement.003.02(E)FEEDING AND SWALLOWING CLINIC. Along with the completed form MC-19: Medical Assistance Provider Agreement, the provider must submit a program overview which demonstrates the following components of service are available within the program: (i) Interdisciplinary team evaluation which provides information to team members on the individual's medical status and nutrition and diet status and also addresses feeding and behavioral concerns. In the process of the interdisciplinary team evaluation, the team must review and consider information from other available resources such as attending or referring physician, nursing home, school;(ii) Assessment by the occupational therapist of the individual's tone and posture to determine seating and positioning for feeding and for the video fluoroscopy procedure;(iii) Examination by the speech pathologist to assess the individual's oral structures and clinical swallowing evaluation;(iv) A video fluoroscopy swallow study to determine conditions which are most favorable for a safe, efficient swallow and management of feeding problems;(v) Assessment of oral motor function and feeding behaviors. Depending on the needs of the individual, some or all of the team members may be involved in this component. This assessment includes presentation of a variety of amounts and types of foods and liquids to the individual to provide additional information used to establish therapeutic intervention;(vi) Conference by team members to review finding, establish priorities, and coordinate treatment and follow-up recommendations; and(vii) Presentation of plan of care to the individual or family, including instruction, demonstration, and written recommendations for feeding procedures at home and in other environments. This may include school, nursing home, or others involved in the individual's care.471 Neb. Admin. Code, ch. 18, § 003
Amended effective 7/5/2022Amended effective 7/10/2022Amended effective 9/17/2024