CMS approves Nebraksa's Medicaid expansion, work requirements

CMS said Oct. 20 that it approved Nebraska's demonstration to expand Medicaid and add work requirements to the program. 

Four things to know: 

1. The expansion applies to adults age 21 through 64 who have an income at or below 138 percent of the federal poverty level. 

2. Work requirements under Nebraska's plan are different than other states, which tie Medicaid eligibility to completion of a set amount of work or education hours per month. Instead, Nebraska will provide what it calls "additional" benefits, including vision, dental and over-the-counter medication coverage, to beneficiaries who meet new requirements.

3. The requirements for additional benefits include attending yearly health visits and completing a health risk assessment, maintaining affordable employer-sponsored coverage if available and not missing more than three scheduled appointments within a six-month period. Beginning in 2022, enrollees also must participate in work, job-seeking activities or education for at least 80 hours a month to get coverage for dental, vision and over-the-counter drugs.

4. The Medicaid demonstration is effective Oct. 20 through March 31, 2026. Implementation will take place April 1, 2021. 

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