Nebraska's Medicaid agency has frozen enrollment of new agency providers in five home and community-based services waivers, including its developmental disabilities waivers, for at least six months from Oct. 1, 2026.

The freeze is set out in Provider Bulletin 26-17 from the Nebraska Department of Health and Human Services (DHHS), issued under the name of interim director Jeremy Brunssen. A second bulletin issued the same day, 26-16, pauses enrollment of new medical equipment and supply companies.

What the moratorium covers

  • Waivers: Family Support (FSW), Developmental Disabilities Adult Day (DDAD), Comprehensive Developmental Disabilities (CDD), Aged and Disabled (AD), and Traumatic Brain Injury (TBI). DHHS's Division of Disability and Aging runs all five.
  • What is blocked: enrollment of new agency providers, and of new locations for agencies already enrolled. The pause applied immediately to all applications.
  • What is not blocked: individual providers. Agencies already enrolled and following current rules keep serving people without interruption.
  • Exception: DHHS may grant an access-to-care exception when it verifies a shortage of a specific waiver service in a rural or underserved county.
  • Length: six months, with possible six-month extensions if DHHS's data shows a continuing need. Applicants turned away only because of the moratorium may reapply after it lifts.

Why Nebraska says it acted

The bulletin cites the federal rule on temporary enrollment moratoria, 42 CFR 455.470, and says the state acted in consultation with the Centers for Medicare & Medicaid Services. DHHS describes the pause as a preventive step against fraud, waste and abuse linked to national trends, and as a response to what it calls a saturation of high-risk providers in some areas, while keeping access to care intact.

The federal rule requires a state to impose a moratorium for an initial six months, to document in writing each six-month extension, and to first determine that the limit won't hurt beneficiaries' access to care.

Why this matters for providers and DSPs

For provider agencies already in Nebraska's 1915(c) waiver programs, the freeze cuts both ways. It slows new competition, but it also blocks growth: a new group home or day program site counts as a new location and can't be enrolled while the pause lasts. Agencies planning to open sites in the next six months should contact the DHHS waiver and provider enrollment offices listed on the bulletin, and ask whether a rural or underserved-county exception could apply.

Because individual providers are exempt, a direct support professional who enrolls independently rather than as an agency can still sign up. Families in thinly served counties may see fewer new agencies to choose from until the moratorium ends.

Nebraska is one of several states tightening provider entry this year. Minnesota paused new HCBS licenses through 2027, and in April CMS asked every state to revalidate high-risk providers.