Nebraska Medicaid’s Managed Care program is now called Heritage Health – which covers medical, pharmacy and behavioral health services.
Calder Lynch, Director of the Division of Medicaid and Long-term Care for the DHHS, says the state selected two new, and one return, company, from the six that bid last spring. He says those who did not select one of the plans during the enrollment months were carefully auto-assigned. But, they were given 90 days from January 1st to make a change, and Lynch says other safeguards have been built in to make this a smooth transition.
“We also have a continuity of care policy that we’ve put into place, where for the first three months, plans are required to pay for out-of-network providers if necessary, to ensure that members can continue to see the provider of their choice. So, if their provider is not in network, they can continue to see them and have the opportunity to switch to a different plan if they want to.”
Lynch says one aspect of Nebraska Medicaid that has not been changed is the long-term care coverage, which is currently under review before a plan is adopted.
He says he feels the DHHS has planned and prepared for this transition carefully enough that the problems with member dissatisfaction and budget overruns that Iowa and some other states have experienced should not be an issue for Nebraska Medicaid.
For more information, the website is neheritagehealth.com or, toll-free 1-888-255-2605, Mon through Friday 7 a.m. to 7 p.m.