ABA Therapy Centers in Nebraska

Heritage Health Medicaid and ABA

Nearly all Nebraska Medicaid and CHIP enrollees receive their medical and behavioral health benefits through a Heritage Health plan, so your plan is the one that authorizes ABA. DHHS service definitions allow up to 30 hours a week and 6 direct hours a day, with more available when medically necessary. Treatment plans must be reviewed at least every 90 days. Prior authorization length depends on medical necessity, so ask the plan how long each approval lasts.

• All three Heritage Health plans are statewide: Molina Healthcare of Nebraska, Nebraska Total Care and UnitedHealthcare Community Plan of Nebraska.
• Schools are an allowed place of service for Medicaid ABA.
• Technicians must hold BACB certification and be enrolled with Nebraska Medicaid.

Neb. Rev. Stat. 44-7,106 and private insurance

Section 44-7,106 requires covered policies to pay for autism screening, diagnosis and treatment for people under 21. ABA falls under behavioral health treatment, which carries a maximum benefit of 25 hours per week until age 21. The statute sets no visit or dollar limit, and an insurer may request a treatment review no more than once every six months. The law reaches self-funded plans only to the extent federal law allows, and it carves out non-grandfathered individual and small group plans that must carry the ACA's required benefit package.

Family Support, CDD and DDAD waivers

Nebraska DHHS runs three developmental disabilities waivers. The Family Support Waiver serves people under 21 who live with family and carries a $10,000 budget per year. The CDD Waiver serves all ages, and the Adult Day Waiver serves ages 21 and over. Every waiver requires Nebraska Medicaid, a developmental disability, and an ICF/IID level of care. Apply through iServe or call (877) 667-6266.

Early Development Network, birth to age three

The Early Development Network (EDN), run by the Nebraska Departments of Education and Health and Human Services, serves children from birth to age three. A child qualifies by not developing typically or by having a diagnosed condition that affects development, so you do not need an autism diagnosis to call. Phone 1-888-806-6287 toll free or 402-471-2471, and EDN connects you with the planning region for your address.

Nebraska's Behavior Analyst Practice Act

Nebraska licenses behavior analysts under the Behavior Analyst Practice Act, sections 38-4401 to 38-4414. DHHS issues two title-protected credentials: Licensed Behavior Analyst, and Licensed Assistant Behavior Analyst for those under close ongoing supervision. The practice definition excludes diagnosis, so a physician or psychologist diagnoses and the behavior analyst designs and oversees treatment. Ask any provider for the supervising analyst's Nebraska license and Medicaid enrollment.