Notice of Applicants for PLHSO License to Bid on HHS Medicaid

Nebraska Department of Insurance Guidance Document IGD - - B2 Title: Notice to Applicants for PLHSO License to Bid on HHS Medicaid Issue Date: October 20, 2022 Previously: Issued as a Notice on August 15, 2016 Notice: This guidance document is advisory in nature but is binding on an agency until amended by such agency. A guidance document does not include internal procedural documents that only affect the internal operations of the agency and does not impose additional requirements or penalties on regulated parties or include confidential information or rules and regulations made in accordance with the Administrative Procedure Act. If you believe that this guidance document imposes additional requirements or penalties on regulated parties, you may request a review of the document. PREPAID LIMITED HEALTH SERVICE ORGANIZATIONS LICENSED ONLY TO SERVE MEDICAID THROUGH HHS CONTRACT NOTICE TO APPLICANTS This guidance document only applies to applicants that seek a Prepaid Limited Health Service Organization (PLHSO) Certificate of Authority strictly for the purpose of contracting with HHS to serve Medicaid. There is no application document for a PLHSO. The Nebraska Department of Insurance (NDOI) requires a cover letter and description of the materials submitted to meet the application requirements at NEB. REV. STAT. § 44-4704(1)-(17). The set of application materials required at § 44- 4704(1)-(17) lists several items that, by nature of the Medicaid program, will not be reviewed as part of the Certificate of Authority application process. • An application only needs to include a cover letter and a list of the materials at § 44- 4704(1), (2), (3), (4), (9), (10), (15) and (16), with enclosed materials clearly marked to correspond with each required subsection of § 44-4704. • Applicants do not need to include the materials described at § 44-4704(5), (6), (7), (8), (11), (12), (13) and (14). Please pay attention to the equity requirements at § 44-4718, demonstrate the required net equity, calculate and arrange for the deposit required at § 44-4718(4), and arrange for the fidelity bond or deposit required at § 44-4719 to avoid delay in the issuance of your Certificate of Authority Questions regarding this guidance document may be directed to the Life and Health Division at 402- 471-2201.