This bill requires Nebraska to allocate $1.5 million annually from the Hospital Quality Assurance and Access Assessment Fund to reimburse mental health providers who serve Medicaid-Medicare dual-eligible patients (people enrolled in both Medicaid and Medicare) for behavioral health services. It mandates that these providers receive the higher Medicaid or Medicare rate for such services, rather than a lower combined rate. The funding applies specifically to providers not operating within hospitals, supporting access to mental health care for vulnerable dual-eligible beneficiaries. The bill explicitly states the Legislature's intent to maintain current Medicaid reimbursement rates for these services in the medical assistance program.
This bill mandates that Nebraska's $462,480,546 appropriation for Medicaid nursing facility rates (Program No. 348) must be fully used in calculating annual rates for fiscal year 2026-27, including the inflation factor. It requires the Department of Health and Human Services to submit two reports: one by August 1, 2026, detailing how the inflation factor was calculated, and another by December 31, 2026, identifying unobligated funds from prior nursing facility appropriations. The bill directly affects Medicaid nursing facilities and the state's Department of Health and Human Services by specifying how funds must be allocated and reported. It declares an emergency to take effect immediately upon approval.
LB 944 amends Nebraska's Medical Assistance Act to require direct reimbursement from the state for hospice care services provided to program participants. This change applies specifically to hospitals and intermediate care facilities that offer hospice services under the program. The bill modifies existing coverage provisions (previously listed in section 68-911(2)(p)) by mandating that payments be made directly to these facilities, rather than through third-party intermediaries. This policy change affects providers delivering hospice care to Medicaid-eligible individuals in Nebraska.
LB 1091 requires Nebraska's Department of Health and Human Services to provide long-term care services (like skilled nursing, nursing facility, and assisted living care) for Medicaid recipients with complex medical needs through fee-for-service Medicaid or other non-risk-based systems - instead of the state's Medicaid managed care program. It directly affects Medicaid recipients with intensive care needs and their healthcare providers, ensuring these services continue outside managed care enrollment. The bill mandates that providers serving these clients cannot be forced to join managed care organizations, while preserving care continuity and preventing increased state costs. Key provisions include defining "special needs" clients and requiring the department to update contracts and rules within six months of the law's effective date.
This bill amends Nebraska's Hospital Quality Assurance and Access Assessment Fund rules to clarify how its funds can be used. It prohibits using the fund to replace existing state hospital payments and specifies exact allocations: up to $15 million annually for administrative costs, $2.5 million for nursing training expansion, and $17.5 million for non-hospital Medicaid providers. The bill also prevents Medicaid managed care organizations and hospitals from adjusting rates based on these directed payments or passing assessment costs to patients. These changes directly affect hospitals, Medicaid managed care organizations, and state agencies managing the fund.
LB 1069 requires emergency care providers (such as ambulance services and emergency clinics) to certify they have a policy for submitting billing claims to third-party payors like Medicare, Medicaid, or private insurers to qualify for state-funded emergency medical services grants. This applies specifically to providers seeking state grant assistance administered by the Nebraska Department of Health and Human Services. The bill defines "billing for services" as the regular submission of claims for reimbursement for both emergency and non-emergency medical care. The requirement is a condition for receiving state grants, and the bill repeals the previous version of the relevant statute.
LB 775 creates the Rural Health Transformation Program within Nebraska's Department of Health and Human Services to improve healthcare in rural areas. The program directly affects rural healthcare providers, patients, and communities by focusing on increasing access, quality, and outcomes through specific mechanisms: supporting health innovations, strengthening provider sustainability, recruiting healthcare workers, developing new care models, and expanding digital health tools. It requires using federal funds received from the Centers for Medicare and Medicaid Services (CMS) exclusively for these purposes, as specified in the bill's funding section. The program aims to transform rural healthcare delivery without specifying new taxes or mandatory requirements.
LB 1016 requires Nebraska's Department of Health and Human Services to apply for a federal waiver by July 1, 2026, to allow Medicaid reimbursement for traditional healing services. This bill directly affects Medicaid beneficiaries, particularly American Indian and Alaska Native communities, by enabling access to culturally grounded health practices previously excluded from coverage. Key provisions mandate tribal consultation in defining services and provider eligibility, ensure traditional healing does not replace standard Medicaid care, and require budget neutrality. The waiver aims to improve health equity through services developed with tribal nations, as specified in the bill's requirement for federal approval under Section 1115 of the Social Security Act.
LB 1043 would amend Nebraska's Medical Assistance Act to remove an exclusion preventing antidepressants, antipsychotics, and anticonvulsants from being considered for inclusion on the state's preferred drug list. This change would allow the Department of Health to evaluate these medications for the preferred list based on therapeutic equivalence and cost-effectiveness (after rebates/discounts), rather than automatically excluding them. The bill directly affects Medicaid beneficiaries who use these prescription drugs, potentially making them more accessible and affordable under the program. It does not create new coverage but changes the process for adding these drug classes to the list.
LB 1132 requires Nebraska's Department of Health and Human Services to file a state plan amendment with federal authorities to add coverage for long-acting injectable and extended-release medications under the Medicaid program. This directly affects Medicaid beneficiaries who require these specific medications as prescribed by a healthcare provider. The bill amends the Medical Assistance Act to mandate this coverage, aligning with federal Medicaid requirements. The key mechanism is the state's obligation to seek federal approval for the coverage change through a formal plan amendment. This is a policy change to expand existing Medicaid benefits, not a new program.
