MedicaidAdministrativeMedium impact
Medically Frail and Substance Use Disorder (SUD) Treatment Program Exemptions for Medicaid Work Requirements
Nebraska Medicaid·NE · Psychiatry, Internal Medicine, General Practice·Specialty Services
Effective date
May 1, 2026
We identified it
Aug 1, 2026
Summary
Nebraska Medicaid has implemented a new exemption process for work requirements affecting medically frail individuals and those in substance use disorder treatment programs. Applicants and beneficiaries must submit an Individual Declaration Form (IDF) to self-declare qualifying conditions; DHHS will use available claims data first to minimize administrative burden. Providers can assist patients in identifying information for the IDF but cannot sign on behalf of patients, and no additional medical documentation is required until January 1, 2028.
Action Required
By January 1, 2028: Billing and clinical staff must be prepared for new medical frailty documentation requirements (details forthcoming from CMS). Immediately: Train front-desk and clinical staff to inform Nebraska Medicaid expansion beneficiaries about the Individual Declaration Form (IDF) process for work requirement exemptions. Providers may assist patients in completing the IDF but cannot sign it; patients or authorized representatives must sign. Direct patients to the DHHS Work Requirements webpage (https://dhhs.ne.gov/Pages/WorkRequirements.aspx) to access the IDF form. Inform patients that DHHS will first attempt to use existing claims data; if insufficient, DHHS will send a Verification of Compliance Notice. Update patient communication materials to explain exemption categories: blindness/disability, substance use disorder, disabling mental health conditions, serious/complex medical conditions, or serious physical/intellectual/developmental disabilities affecting activities of daily living. Do NOT submit provider-signed medical documentation at this time; if voluntarily submitting medical records, ensure patient-signed IDF accompanies submission. Contact DHHS.MLTCExperience@nebraska.gov with questions.