reglab/housing_qa huggingface dataset:
NE Code § 44-6905 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6905 - Director, defined.

44-6905.  Director, defined.Director means the Director of Insurance.Source  Laws 1997, LB 862, § 5.
NE Code § 44-6905.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6905.01 - Enrollment date, defined.

44-6905.01.  Enrollment date, defined.Enrollment date means the first day of coverage in the health benefit plan or, if earlier, the first day of the waiting period.Source Laws 2000, LB 1253, § 39.
NE Code § 44-6906 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6906 - Governmental plan, defined.

44-6906.  Governmental plan, defined.Governmental plan means a plan as defined under 29 U.S.C. 1002 and any plan maintained for its employees by the United States Government or by any agency or instrumentality of the United States Government.Source  Laws 1997, LB 862, § 6.
NE Code § 44-6907 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6907 - Group health plan, defined.

44-6907.  Group health plan, defined.Group health plan means an employee welfare benefit plan as defined by 29 U.S.C. 1002 to the extent that the plan provides any hospital, surgical, or medical expense benefits to employees or their dependents, as defined under the terms of the plan, directly or through insurance, reimbursement, or otherwise.Source  Laws 1997, LB 862, § 7.
NE Code § 44-6908 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6908 - Health benefit plan, defined.

44-6908.  Health benefit plan, defined.(1) Health benefit plan means any employer group hospital or medical policy or certificate or employer group health maintenance organization subscriber contract.(2) Health benefit plan does not include one or more, or any combination, of the following:(a) Coverage only for accident or disability income insurance, or any combination thereof;(b) Coverage issued as a supplement to liability insurance;(c) Liability insurance, including general liability insurance and automobile liability insurance;(d) Workers' compensation or similar insurance;(e) Automobile medical payment insurance;(f) Credit-only insurance;(g) Coverage for onsite medical clinics; and(h) Other similar insurance coverage, specified in federal regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.(3) Health benefit plan does not include the following benefits if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of the plan:(a) Limited-scope dental or vision benefits;(b) Benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; and(c) Such other similar, limited benefits as are specified in federal regulations.(4) Health benefit plan does not include the following benefits if the benefits are provided under a separate policy, certificate, or contract of insurance, there is no coordination between the provision of the benefits and any exclusion of benefits under any group health benefit plan maintained by the same plan sponsor, and such benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor:(a) Coverage only for a specified disease or illness; and(b) Hospital indemnity or other fixed indemnity insurance.(5) Health benefit plan does not include the following if it is offered as a separate policy, certificate, or contract of insurance:(a) Medicare supplemental health insurance as defined under section 1882(g)(1) of the Social Security Act;(b) Coverage supplemental to the coverage provided under 10 U.S.C. chapter 55, as such chapter existed on January 1, 2003; and(c) Similar supplemental coverage provided to coverage under a group health plan.Source   Laws 1997, LB 862, § 8;  Laws 2003, LB 6, § 5.
NE Code § 44-6909 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6909 - Health carrier, defined.

44-6909.  Health carrier, defined.Health carrier means any entity that provides a health benefit plan including an insurance company, a fraternal benefit society, a health maintenance organization, and any other entity providing a plan of health insurance or health benefits subject to state insurance regulation.Source  Laws 1997, LB 862, § 9.
NE Code § 44-6909.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6909.01 - Health maintenance organization, defined.

44-6909.01.  Health maintenance organization, defined.Health maintenance organization means a person that undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis, except for enrollee responsibility for copayments or deductibles or both.Source Laws 2002, LB 1139, § 45.
NE Code § 44-6910 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6910 - Health-status-related factor, defined.

44-6910.  Health-status-related factor, defined.Health-status-related factor means any of the following factors:(1) Health status;(2) Medical condition, including both physical and mental illnesses;(3) Claims experience;(4) Receipt of health care;(5) Medical history;(6) Genetic information;(7) Evidence of insurability, including conditions arising out of acts of domestic violence; and(8) Disability.Source  Laws 1997, LB 862, § 10.
NE Code § 44-6911 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6911 - Late enrollee, defined.

44-6911.  Late enrollee, defined.Late enrollee means an eligible employee or dependent who requests enrollment in a health benefit plan following the initial enrollment period during which the individual is entitled to enroll under the terms of the health benefit plan if the initial enrollment period is a period of at least thirty days. An eligible employee or dependent shall not be considered a late enrollee if:(1) The individual meets each of the following:(a) The individual was covered under creditable coverage at the time of the initial enrollment;(b) The individual lost coverage under creditable coverage as a result of termination of employment or eligibility, reduction in the number of hours of employment, the involuntary termination of the creditable coverage, death of a spouse, divorce, or legal separation; and(c) The individual requests enrollment within thirty days after termination of the creditable coverage;(2) The individual is employed by an employer which offers multiple health benefit plans and the individual elects a different plan during an open enrollment period;(3) A court has ordered coverage be provided for a spouse or minor or dependent child under a covered employee's health benefit plan and request for enrollment is made within thirty days after issuance of the court order; or(4) The individual had coverage under a COBRA continuation provision and the coverage under that provision was exhausted.Source  Laws 1997, LB 862, § 11.
NE Code § 44-6912 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6912 - Medical care, defined.

44-6912.  Medical care, defined.Medical care means amounts paid for:(1)(a) The diagnosis, care, mitigation, treatment, or prevention of disease or (b) the purpose of affecting any structure or function of the body;(2) Transportation primarily for and essential to medical care referred to in subdivision (1) of this section; and(3) Insurance covering medical care referred to in subdivisions (1) and (2) of this section.Source  Laws 1997, LB 862, § 12.
NE Code § 44-6913 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6913 - Network plan, defined.

44-6913.  Network plan, defined.Network plan means health insurance coverage offered by a health carrier under which the financing and delivery of medical care including items and services paid for as medical care are provided, in whole or in part, through a defined set of providers under contract with the health carrier.Source  Laws 1997, LB 862, § 13.
NE Code § 44-6914 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6914 - Plan sponsor, defined.

44-6914.  Plan sponsor, defined.Plan sponsor has the meaning given such term under 29 U.S.C. 1002.Source  Laws 1997, LB 862, § 14.
NE Code § 44-6915 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6915 - Preexisting condition, defined.

44-6915.  Preexisting condition, defined.Preexisting condition means a condition whether physical or mental, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the six-month period ending on the enrollment date. Genetic information shall not be treated as a condition for which a preexisting condition exclusion may be imposed in the absence of a diagnosis of the condition related to such information.Source   Laws 1997, LB 862, § 15;  Laws 2000, LB 1253, § 40.
NE Code § 44-6915.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6915.01 - Waiting period, defined.

44-6915.01.  Waiting period, defined.Waiting period means the period that must pass with respect to an individual before the individual is eligible to be covered for benefits under the terms of the health benefit plan. If an individual enrolls as a late enrollee or on a special enrollment date, any period before such late or special enrollment is not a waiting period.Source Laws 2000, LB 1253, § 41.
NE Code § 44-6917.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6917.01 - Certification of creditable coverage.

44-6917.01.  Certification of creditable coverage.(1) Health carriers shall provide written certification of creditable coverage to individuals in accordance with subsection (2) of this section.(2) The certification of creditable coverage shall be provided:(a) At the time an individual ceases to be covered under the health benefit plan or otherwise becomes covered under a COBRA continuation provision;(b) In the case of an individual who becomes covered under a COBRA continuation provision, at the time the individual ceases to be covered under that provision; and(c) At the time a request is made on behalf of an individual if the request is made not later than twenty-four months after the date of cessation of coverage described in subdivision (2)(a) or (b) of this section, whichever is later.(3) Health carriers may provide the certification of creditable coverage required under subdivision (2)(a) of this section at a time consistent with notices required under any applicable COBRA continuation provision.(4) The certificate of creditable coverage required to be provided pursuant to subsection (1) of this section shall contain:(a) Written certification of the period of creditable coverage of the individual under the health benefit plan and the coverage, if any, under the applicable COBRA continuation provision; and(b) The waiting period, if any, and, if applicable, affiliation period imposed with respect to the individual for any coverage under the health benefit plan.(5) To the extent medical care under a group health plan consists of group health insurance coverage, the plan is deemed to have satisfied the certification requirement under subsection (1) of this section if the health carrier offering the coverage provides for certification in accordance with subsection (2) of this section.(6)(a) If an individual enrolls in a group health plan that uses the alternative method of counting creditable coverage pursuant to subdivision (6)(c) of section 44-6916 and the individual provides a certificate of coverage that was provided to the individual pursuant to subsection (3) of this section, on request of the group health plan, the entity that issued the certification to the individual promptly shall disclose to the group health plan information on the classes and categories of health benefits available under the entity's health benefit plan.(b) The entity providing the information pursuant to subdivision (6)(a) of this section may charge the requesting group health plan the reasonable cost of disclosing the information.Source Laws 2002, LB 1139, § 47.
NE Code § 44-6918 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6918 - Rules and regulations.

44-6918.  Rules and regulations.The director may adopt and promulgate rules and regulations to carry out sections 44-6901 to 44-6918.Source   Laws 1997, LB 862, § 18;  Laws 2000, LB 1253, § 42;  Laws 2002, LB 1139, § 48.
NE Code § 44-7001 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7001 - Act, how cited.

44-7001.  Act, how cited.Sections 44-7001 to 44-7013 shall be known and may be cited as the Health Care Professional Credentialing Verification Act.Source  Laws 1998, LB 1162, § 26.
NE Code § 44-7002 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7002 - Purpose and intent.

44-7002.  Purpose and intent.The Health Care Professional Credentialing Verification Act requires a health carrier to establish a comprehensive health care professional credentialing verification program to ensure that its participating health care professionals meet specific minimum standards of professional qualification. The standards set out in the act address the initial credentialing verification and subsequent recredentialing process.Source  Laws 1998, LB 1162, § 27.
NE Code § 44-7004 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7004 - Applicability of act.

44-7004.  Applicability of act.The Health Care Professional Credentialing Verification Act applies to health carriers that offer closed plans or combination plans having a closed component.Source  Laws 1998, LB 1162, § 29.
NE Code § 44-7005 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7005 - Use of nationally recognized private accrediting entities; authorized.

44-7005.  Use of nationally recognized private accrediting entities; authorized.The director may recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Health Care Professional Credentialing Verification Act. A recognized accrediting entity shall make available to the director its current standards to demonstrate that the entity's standards meet or exceed this state's requirements. The health carrier may provide the director with documentation that a managed care plan has been accredited by the entity.Source  Laws 1998, LB 1162, § 30.
NE Code § 44-7006 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7006 - Health carrier; credentialing verification duties.

44-7006.  Health carrier; credentialing verification duties.(1) A health carrier shall:(a) Establish written policies and procedures for credentialing verification of all health care professionals with whom the health carrier contracts and apply these standards consistently;(b) Verify the credentials of a health care professional before entering into a contract with that health care professional. The medical director of the health carrier or other designated health care professional shall have responsibility for, and shall participate in, credentialing verification;(c) Establish a credentialing verification committee consisting of licensed physicians and other health care professionals to review credentialing verification information and supporting documents and make decisions regarding credentialing verification;(d) Make available for review by the applying health care professional upon written request all application and credentialing verification policies and procedures;(e) Retain all records and documents relating to a health care professional's credentialing verification process for at least five years; and(f) Keep confidential all information obtained in the credentialing verification process except as otherwise provided by law.(2) Nothing in the Health Care Professional Credentialing Verification Act shall be construed to require a health carrier to select a provider as a participating provider solely because the provider meets the health carrier's credentialing verification standards or to prevent a health carrier from utilizing separate or additional criteria in selecting the health care professionals with whom it contracts.(3) The policies and procedures for credentialing verification shall be available for review by the director, and, in the case of a health maintenance organization, shall also be available for review by the chief medical officer, if one is appointed pursuant to section 81-3115, and if not, then the Director of Public Health.Source   Laws 1998, LB 1162, § 31;  Laws 2007, LB296, § 198.
NE Code § 44-7007 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7007 - Health carrier; primary verification; secondary verification; duties.

44-7007.  Health carrier; primary verification; secondary verification; duties.A health carrier shall:(1) Obtain primary verification of at least the following information about the applicant:(a) Current license, certificate, or registration to practice a health care profession in this state and history of licensure, certification, or registration;(b) Current level of professional liability coverage, if applicable;(c) Status of hospital privileges, if applicable;(d) Specialty board certification status, if applicable;(e) Current federal Drug Enforcement Agency registration certificate, if applicable;(f) Graduation from a health care professional school; and(g) Completion of postgraduate training, if applicable;(2) Obtain, subject to either primary or secondary verification at the health carrier's discretion:(a) The health care professional's licensure, certification, or registration history in this and all other states;(b) The health care professional's malpractice history; and(c) The health care professional's practice history;(3) At least every three years obtain primary verification of a participating health care professional's:(a) Current license, certificate, or registration to practice a health care profession in this state;(b) Current level of professional liability coverage, if applicable;(c) Status of hospital privileges, if applicable;(d) Current federal Drug Enforcement Agency registration certificate, if applicable; and(e) Specialty board certification status, if applicable; and(4) Require all participating providers to notify the health carrier of changes in the status of any of the items listed in this section at any time and identify for participating providers the individual to whom they should report changes in the status of an item listed in this section.Source  Laws 1998, LB 1162, § 32.
NE Code § 44-7008 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7008 - Health care professional's right to review credentialing verification information.

44-7008.  Health care professional's right to review credentialing verification information.(1) A health carrier shall provide a health care professional the opportunity to review and correct information submitted in support of that health care professional's credentialing verification application as set forth below.(2)(a) Each health care professional who is subject to the credentialing verification process shall have the right to review all information, including the source of that information, obtained by the health carrier to satisfy the requirements of the Health Care Professional Credentialing Verification Act during the health carrier's credentialing process.(b) A health carrier shall notify a health care professional of any information obtained during the health carrier's credentialing verification process that does not meet the health carrier's credentialing verification standards or that varies substantially from the information provided to the health carrier by the health care professional, except that the health carrier shall not be required to reveal the source of information if the information is not obtained to meet the requirements of the act or if disclosure is prohibited by law.(c) A health care professional shall have the right to correct any erroneous information. A health carrier shall have a formal process by which a health care professional may submit supplemental or corrected information to the health carrier's credentialing verification committee and request a reconsideration of the health care professional's credentialing verification application if the health care professional feels that the health carrier's credentialing verification committee has received information that is incorrect or misleading. Supplemental information shall be subject to confirmation by the health carrier.Source  Laws 1998, LB 1162, § 33.
NE Code § 44-7009 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7009 - Contracts; duties.

44-7009.  Contracts; duties.Whenever a health carrier contracts to have another entity perform the credentialing functions required by the Health Care Professional Credentialing Verification Act or applicable rules and regulations, the director shall hold the health carrier responsible for monitoring the activities of the entity with which it contracts and for ensuring that the requirements of the act and applicable rules and regulations are met.Source  Laws 1998, LB 1162, § 34.
NE Code § 44-7010 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7010 - Health carrier violation; notice; hearing.

44-7010.  Health carrier violation; notice; hearing.If the director finds that any health carrier doing business in this state is engaging in any violation of the Health Care Professional Credentialing Verification Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days after the date of the notice.Source  Laws 1998, LB 1162, § 35.
NE Code § 44-7011 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7011 - Violation; penalty.

44-7011.  Violation; penalty.If, after the hearing, the director finds a health carrier has violated the Health Care Professional Credentialing Verification Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Health Care Professional Credentialing Verification Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.Source  Laws 1998, LB 1162, § 36.
NE Code § 44-7012 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7012 - Violation of cease and desist order; penalty.

44-7012.  Violation of cease and desist order; penalty.Any health carrier who violates a cease and desist order of the director under section 44-7011 may after notice and hearing and upon order of the director be subject to:(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and(2) Suspension or revocation of the health carrier's certificate of authority.Source  Laws 1998, LB 1162, § 37.
NE Code § 44-7013 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-7013 - Rules and regulations.

44-7013.  Rules and regulations.The director may adopt and promulgate rules and regulations to carry out the Health Care Professional Credentialing Verification Act.Source  Laws 1998, LB 1162, § 38.