LB 146 proposes a 12.5% increase in reimbursement rates for dental services provided under Nebraska's Medical Assistance Act (Medicaid) for fiscal year 2025-26. This bill directly affects dentists and dental clinics that serve Medicaid patients by raising the state's payment for covered dental procedures. The legislation states the Legislature's intent to appropriate funds for this rate increase, which would improve payments for providers but does not expand eligibility or coverage. It declares an emergency to allow immediate implementation upon approval. The bill is currently pending before the Appropriations Committee.
LB 283 requires Nebraska's Department of Health and Human Services to implement "express lane eligibility" for Medicaid and Children's Health Insurance Program (CHIP) enrollment by using existing Supplemental Nutrition Assistance Program (SNAP) data. This means eligible children who already receive SNAP benefits will be automatically enrolled in Medicaid or CHIP without needing separate applications, covering initial applications, renewals, and automatic updates. The bill directs the state to submit federal plan amendments by October 2025, with implementation starting January 1, 2026. It specifically affects children in SNAP households who qualify for medical assistance programs. The policy change streamlines enrollment by leveraging existing federal data sharing.
LB 527 creates a Medicaid Access and Quality Fund by imposing a 6% tax on certain health insurance premiums starting January 2026. The fund will increase payments to nonhospital Medicaid providers (like clinics and doctors) to improve access to care, especially for rural patients, pregnant women, and children. It also allocates $75 monthly per patient to primary care providers who serve as medical homes for Medicaid beneficiaries. This directly affects Nebraska Medicaid beneficiaries, healthcare providers, and insurance companies paying the tax.
LB 365 requires Nebraska's Medicaid program (Medical Assistance Act) to cover and reimburse for home blood pressure monitoring devices when prescribed by a healthcare provider. This directly affects Medicaid beneficiaries who need regular blood pressure monitoring for conditions like hypertension. The bill amends existing coverage rules to add these services to the list of covered medical supplies, similar to how continuous glucose monitors were recently added. It mandates the Department of Health and Human Services to provide this coverage without additional cost to eligible patients.
Nebraska's LB 253 requires health insurers and Medicaid to cover biomarker testing for diagnosis, treatment, or monitoring of diseases when supported by medical evidence. This includes tests approved by the FDA, aligned with drug labels, or recommended by nationally recognized clinical guidelines. Insurers must cover these tests without unnecessary delays, approving or denying prior authorization requests within 24-72 hours, and provide clear exception processes for patients. The law applies to all health insurers and Medicaid plans in Nebraska, effective January 1, 2026, directly affecting patients needing these tests and healthcare providers ordering them.
LB 621 mandates annual transfers from Nebraska's Medicaid Intergovernmental Trust Fund and Tobacco Settlement Trust Fund into the Nebraska Health Care Cash Fund. It specifies exact transfer amounts (e.g., $61.654 million for 2025-26) and requires adjustments based on unused funds in the Health Care Cash Fund. The bill also directs funding for community health centers (e.g., $700,000 per center for expanded services like dental or behavioral health) and pancreatic cancer research at UNMC, contingent on matching private funds. These transfers and funding allocations are legally required, with the State Treasurer responsible for implementation.
Nebraska's LB 701 mandates that the Department of Health and Human Services reimburse providers for doula services by state funds starting January 1, 2027. It directly affects Medicaid recipients seeking pregnancy and birth support, as doulas provide non-clinical emotional, physical, and informational care before, during, and after childbirth. The bill requires the department to establish a diverse work group (including doulas, communities of color, rural representatives, and birth advocates) by October 2026 to set reimbursement rates and define training/certification standards. This policy aims to improve birth outcomes - reducing cesarean rates, interventions, and complications - by integrating doula support into state Medicaid coverage.
Nebraska's LB 77 adopts the Ensuring Transparency in Prior Authorization Act, requiring health insurers and Medicaid to clearly explain prior authorization decisions and post all requirements online by 2027. The law mandates that denials must be reviewed by a physician (or clinical peer) and include specific reasons citing coverage criteria, with expedited reviews for urgent care. It also requires insurers to cover biomarker testing - tests that identify specific biological markers for diagnosis - when prescribed by a doctor. This directly affects health insurers, providers, and patients by increasing transparency in coverage decisions and expanding access to certain diagnostic tests.
This bill appropriates $1 million from the Medicaid Managed Care Excess Profit Fund for each of fiscal years 2025-26 and 2026-27 to the Nebraska Department of Health and Human Services. The funds are specifically designated for Program 33 to support the implementation of Legislative Bill 48 (which establishes Medicaid managed care reforms). The appropriation includes a $60,000 annual cap on salary and per diem expenses for the program. The bill becomes effective September 1, 2025, and directly affects Medicaid program administration.
