Nebraska Passes Bill to Increase Transparency in Medicaid Waiver Assessments

Families raise concerns over funding reductions and unsuccessful appeals

Apr. 11, 2026 at 12:04am

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A dimly lit government office with a lone wheelchair in the center, the chair casting long shadows across the floor and walls, conveying a sense of isolation and disconnect from the real-world experiences of those relying on the Medicaid waiver program.The shadows cast by a lone wheelchair in a government office symbolize the disconnect between bureaucratic assessments and the real-world needs of individuals with developmental disabilities.Albion Today

The Nebraska legislature has passed a bill that requires more transparency in the state's developmental disabilities Medicaid waiver assessment system. The bill comes after families across the state have raised concerns about funding reductions and a 0% success rate for appeals of the new assessment process implemented by the Nebraska Department of Health and Human Services (DHHS).

Why it matters

The developmental disabilities waiver program helps individuals stay out of facilities and receive care at home, but the new assessment system implemented by DHHS last summer has led to funding reductions for some families despite no changes to their needs. Advocates argue the new system is not accurately capturing the real-world functionality of individuals and is resulting in unsuccessful appeals.

The details

DHHS previously used multiple tools to assess funding for the waiver but switched to a single system last summer, citing cost savings for the state. DHHS said hundreds of families have appealed their assessments, but none of the 323 appeals have been successful. The new bill, LB 958, will require DHHS to provide more explanations of the assessment system's results and the algorithms it uses.

  • DHHS implemented the new assessment system in the summer of 2025.
  • Between July 2025 and March 2026, 17% of applicants were assessed at a lower funding tier.

The players

Nebraska Department of Health and Human Services (DHHS)

The state agency responsible for administering the developmental disabilities Medicaid waiver program and implementing the new assessment system.

Carol Salber

A parent of a son who qualifies for the waiver and a clinician who focuses on mental health. Salber has been advocating for families impacted by the new assessment system.

Sen. Machaela Cavanaugh

The Nebraska state senator who proposed LB 958, the bill aimed at increasing transparency in the waiver assessment process.

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What they’re saying

“It's very concerning just from a clinical perspective of looking at an assessment that is not generating a result that is congruent with other results and does not seem to look at all of the information equally.”

— Carol Salber, Parent and Clinician

“That's very concerning. And I think if no families are overturning these appeals or are winning these appeals, I think it's fair to ask the question, why?”

— Carol Salber, Parent and Clinician

“It's a real-world disconnect between what our individuals and our loved ones really functionally do when in the real world versus what this algorithm is spit out.”

— Carol Salber, Parent and Clinician

What’s next

LB 958 now awaits the governor's signature to become law, which would require DHHS to provide more transparency around the waiver assessment system and its results.

The takeaway

The passage of LB 958 represents a step forward in addressing the concerns of families who have faced funding reductions and unsuccessful appeals under the new Medicaid waiver assessment system. However, advocates caution that the bill does not guarantee the reversal of previous assessment decisions, underscoring the need for continued oversight and reform to ensure the system accurately reflects the real-world needs of individuals with developmental disabilities.