1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)
Role: Administers Medicaid waiver funding for Home Modification Services and manages provider enrollment, service authorization, and reimbursement

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division
Role: Ensures quality standards, service delivery, and compliance for Home Modification Services under HCBS waiver programs

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Home Modifications meet HCBS quality, person-centered planning, and participant protection standards

2. HOME MODIFICATION SERVICES OVERVIEW

Home Modification Services are designed to improve the safety and accessibility of the living environment for individuals with disabilities or mobility challenges.

Approved providers may deliver:

• Accessibility Improvements: Installation of ramps, widened doorways, and handrails
• Bathroom Modifications: Roll-in showers, grab bars, accessible sinks, and raised toilet seats
• Kitchen Adjustments: Lowered countertops, accessible cabinets, and modified appliances
• Safety Enhancements: Installation of safety alarms, improved lighting, and slip-resistant flooring
• Mobility Aids: Stairlifts, vertical platform lifts, and handrails
• Environmental Controls: Smart home systems for lighting, temperature, and security management
• Structural Modifications: Doorframe adjustments, hallway widening, and accessible entryways

All modifications must be in accordance with the Individualized Service Plan (ISP) and based on a professional assessment of the participant’s needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Nebraska Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid Waiver Home Modification provider via the Nebraska Medicaid Provider Enrollment Portal
• Obtain any required contractor licenses through the Nebraska Department of Labor
• Maintain general liability and professional liability insurance
• Develop comprehensive policies for safety, project planning, and quality assurance
• Ensure contractors and subcontractors meet background checks and licensing requirements

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Home Modification Services under HCBS waivers

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, contractor licenses, insurance certificates, and policy manuals

Program Readiness Review:

• DHHS evaluates provider readiness, including safety procedures, modification protocols, and contractor qualifications

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Home Modification Services using designated billing codes

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Nebraska Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Contractor Licenses (if applicable)
• Proof of general and professional liability insurance

Home Modification Services Policy & Procedure Manual including:

• Safety and risk assessment protocols
• Home modification planning and approval procedures
• Contractor vetting, background checks, and credential verification
• Compliance with building codes, ADA standards, and safety regulations
• Medicaid billing, project tracking, and audit readiness procedures
• Documentation standards for project completion and client satisfaction
• Emergency preparedness and risk management protocols

6. STAFFING REQUIREMENTS

Role: Home Modification Program Director
Requirements: Bachelor’s degree in construction management, healthcare administration, or related field, experience in home accessibility projects preferred.

Role: Licensed Contractors
Requirements: State contractor license, experience in home modifications for accessibility, background clearance.

Role: Accessibility Specialists
Requirements: Certification in home accessibility modifications (e.g., CAPS - Certified Aging-in-Place Specialist); background clearance.

All staff must complete:

• Safety training and risk management education
• HIPAA compliance and participant rights training
• Ongoing professional development and continuing education
• Annual competency evaluations and safety protocol updates

7. MEDICAID WAIVER PROGRAMS

Home Modification Services are available under the following Nebraska Medicaid Waivers:

• Aged and Disabled (AD) Waiver
• Traumatic Brain Injury (TBI) Waiver
• Developmental Disabilities (DD) Waiver
• Children with Disabilities Waiver
• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Installation of wheelchair ramps and accessible doorways
• Bathroom accessibility improvements (e.g., roll-in showers, grab bars)
• Kitchen modifications to accommodate mobility aids
• Safety enhancements and adaptive equipment installations
• Smart home integration for individuals with mobility impairments

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months

Phase: Nebraska Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days

Phase: Medicaid Billing Setup and Home Modification Service Launch
Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)
Website: https://dhhs.ne.gov/

Nebraska Department of Labor
Website: https://dol.nebraska.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division
Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/

​

10. SCOPE OF WORK

• Business registration, Medicaid enrollment, and contractor licensing assistance
• Policy manual development for home accessibility planning and safety compliance
• Contractor credentialing, training program templates, and documentation guidance
• Medicaid billing system setup and project management support
• Branding, website development, and client engagement strategies
• Quality assurance systems for safety monitoring and compliance
• Networking with healthcare providers and community organizations for referrals