471 Neb. Admin. Code, ch. 35, § 003
Certain Medicaid clients are required to participate in the Nebraska Medicaid Managed Care Program (known as the Nebraska Health Connection). The Department developed the NHC to improve the health and wellness of Nebraska's Medicaid clients by increasing their access to comprehensive health services in a way that is cost effective to the State. The NHC was implemented on July 1, 1995. Enrollment in the NHC is mandatory for certain clients in designated geographic areas of the state. NHC clients will receive a Nebraska Medicaid Identification Card. Participation in NHC can be verified by accessing the Department Internet Access for Enrolled Providers (www.dhhs.ne.gov/med/internetaccess.htm): the Nebraska Medicaid Eligibility System (NMES) at 800-642 -6092 (in Lincoln, 471-9580) (see 471-000-124); the Medicaid Inquiry Line at 877-255 -3092 (in Lincoln 471-9128); or electronically using the standard Health Care Eligibility Benefit Inquiry and Response transaction (ASC X12N 270/271).
The NHC utilizes two models of managed care plans to provide the basic benefits package; these models are health maintenance organizations (HMO's) and primary care case management (PCCM) networks. The NHC also provides a mental health and substance abuse benefits package on a statewide basis available to all clients who are required to participate in NHC.
If a client is required to participate in the NHC, all services contained in the benefits package (MH/SA or medical) must be provided under the management of the managed care plan.
471 Neb. Admin. Code, ch. 35, § 003