reglab/housing_qa huggingface dataset:
NE Code § 44-779 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-779 - Group sickness and accident insurance; coverage for the treatment of alcoholism; requirements.

44-779.  Group sickness and accident insurance; coverage for the treatment of alcoholism; requirements.After January 1, 1981, all policies or contracts of group sickness and accident insurance written or issued by insurance companies and all group contracts or certificates written or issued by a health maintenance organization as to which there is a premium change or which are delivered or issued for delivery in this state, which do not provide at least basic coverage for the treatment of alcoholism, shall be subject to the following:(1) The written sales and advertising literature, the descriptive brochures, and the exclusion sections of such policy, contract, or certificate shall contain a notice in all capital letters in the following language or in words of similar effect as approved by the Director of Insurance: This agreement does not provide basic coverage for the treatment of alcoholism. Coverage for treatment of alcoholism is available if you specifically request it and then only upon such terms and conditions as you and the company agree;(2) The written sales and advertising literature, the descriptive brochures, and such policy, contract, or subscription agreement itself shall not, in describing the plan, contract, coverage, or benefits, use the words comprehensive;(3) The definition of a facility, program, or agency in or through which covered alcoholism services may be rendered contained in any optional coverage shall not be more restrictive than the definitions contained in sections 44-771 to 44-775 if the effect of such definitions would be to limit, deny, or withhold benefits which would be available if the definitions used in sections 44-769 to 44-781 were applied;(4) Such policy, contract, or subscription agreement shall provide benefits to any person covered thereunder for the treatment of alcoholism under such terms and conditions as may be agreed upon between the subscriber or insured and the insurer or health maintenance organization; and(5) In the case of policies, contracts, and subscription agreements issued before January 1, 1981, as to which there is a premium change after January 1, 1981, the notification requirements of this section may be met by written endorsement to such policy, contract, or subscription agreement.Source   Laws 1980, LB 646, § 11;   Laws 1989, LB 92, § 159.
NE Code § 44-780 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-780 - Basic coverage for treatment of alcoholism; when considered available.

44-780.  Basic coverage for treatment of alcoholism; when considered available.An insurance company or health maintenance organization will be considered to be providing basic coverage for treatment of alcoholism if it makes benefits available for the treatment described in section 44-778 on terms involving durational limits, dollar limits, deductibles, and coinsurance which are no less favorable than the terms on which it makes benefits available for the treatment of physical illness generally.Source   Laws 1980, LB 646, § 12;   Laws 1989, LB 92, § 160.
NE Code § 44-781 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-781 - Coverage for treatment of alcoholism; benefits available.

44-781.  Coverage for treatment of alcoholism; benefits available.An insurance company or health maintenance organization which does not provide basic coverage for treatment of alcoholism may nevertheless provide different or lesser benefits. Nothing in sections 44-769 to 44-781 is intended to limit any insurance company or health maintenance organization from providing more coverage for the treatment of alcoholism than is described in section 44-778.Source   Laws 1980, LB 646, § 13;   Laws 1989, LB 92, § 161.
NE Code § 44-782 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-782 - Health insurance provider; coverage of mental or nervous disorders; requirements.

44-782.  Health insurance provider; coverage of mental or nervous disorders; requirements.No insurance company, health maintenance organization, or other health insurance provider shall deny payment for treatment of mental or nervous disorders under a policy, contract, certificate, or other evidence of coverage issued or delivered in Nebraska on the basis that the hospital or state institution licensed as a hospital by the Department of Health and Human Services and defined in section 71-419 providing such treatment is publicly funded and charges are reduced or no fee is charged depending on the patient's ability to pay.Source   Laws 1985, LB 487, § 1;   Laws 1989, LB 92, § 162;   Laws 1996, LB 1044, § 240;  Laws 2000, LB 819, § 71;  Laws 2007, LB296, § 177.
NE Code § 44-783 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-783 - Health insurance insurer; choice of pharmacy; limitation; when.

44-783.  Health insurance insurer; choice of pharmacy; limitation; when.(1) If any insurer authorized to transact the business of health insurance in this state reasonably determines that an insured's utilization of prescription medications has been excessive and has not been medically necessary as defined by the insured's coverage, the insurer may reserve the right to limit such insured to a pharmacy of the insured's choice for obtaining prescription drug benefits. If the insured's coverage is through a preferred provider organization, the insurer or preferred provider organization may limit the insured to a preferred provider pharmacy of the insured's choice. If an insured has been so limited, the insurer or preferred provider organization shall not be required to provide benefits for prescriptions obtained from any other pharmacy. The insurer or preferred provider organization may require that the insured provide written notification to the insurer or preferred provider organization of the insured's choice of pharmacy.(2) The action by the insurer or preferred provider organization limiting an insured to one pharmacy of the insured's choice may be effective as of the date specified in a written notice to the insured. Such written notice shall be sent to the insured at his or her last-known address as shown by the records of the insurer or preferred provider organization by certified or registered mail and shall inform the insured that he or she is required to select one pharmacy for obtaining prescription drug benefits. The terms of the written notice shall allow the insured at least seven days to notify the insurer or preferred provider organization of his or her choice of pharmacy.Source  Laws 1993, LB 536, § 19.
NE Code § 44-784 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-784 - Coverage for childhood immunizations; requirements.

44-784.  Coverage for childhood immunizations; requirements.Notwithstanding section 44-3,131, any expense-incurred group sickness and accident insurance policy, certificate, or subscriber contract delivered, issued for delivery, or renewed after January 1, 1995, or any expense-incurred individual sickness and accident insurance policy, certificate, or subscriber contract delivered or issued for delivery after such date that provides coverage for a dependent child under six years of age shall provide coverage for childhood immunizations. Benefits for childhood immunizations shall be exempt from any deductible provision contained in the applicable policy. Copayment, coinsurance, and dollar-limit provisions applicable to other medical services may be applied to the childhood immunization benefits. This section shall not apply to any individual or group policies that provide coverage for a specified disease, accident-only coverage, hospital indemnity coverage, medicare supplement coverage, long-term care coverage, or other limited-benefit coverage.For purposes of this section, childhood immunizations shall mean the complete set of vaccinations for children from birth to six years of age for immunization against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, tetanus, and haemophilus influenzae type B.Source   Laws 1994, LB 1222, § 46;  Laws 2007, LB63, § 1.
NE Code § 44-785 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-785 - Coverage for screening mammography; requirements.

44-785.  Coverage for screening mammography; requirements.(1) Notwithstanding section 44-3,131, (a) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provide coverage for a specified disease or other limited-benefit coverage, and (b) any self-funded employee benefit plan to the extent not preempted by federal law shall include coverage for screening mammography as follows:(i) For women who are thirty-five years of age and older but younger than forty years of age, one base-line mammogram between thirty-five and forty years of age;(ii) For women who are forty years of age and older but younger than fifty years of age, one mammogram every two years or more frequently based on the patient's physician's recommendation; and(iii) For women who are fifty years of age or older, one mammogram every year.(2) This section does not prevent application of deductible or copayment provisions contained in the policy or health benefit plan or require that coverage under an individual or group policy or health benefit plan be extended to any other procedures. The coverage provided by this section shall not be less favorable than for other radiological examinations. This section does not apply if the covered individuals are provided an ongoing screening mammography program which at a minimum meets the requirements of this section as a separate benefit.(3) For purposes of this section, screening mammography shall mean radiological examination of the breast of asymptomatic women for the early detection of breast cancer, which examination shall include (a) a cranio-caudal and a medial lateral oblique view of each breast and (b) a licensed radiologist's interpretation of the results of the procedure. Screening mammography shall not include diagnostic mammography, additional projections required for lesion definition, breast ultrasound, or any breast interventional procedure. Screening mammography shall be performed by a mammogram supplier who meets the standards of the federal Mammography Quality Standards Act of 1992.Source  Laws 1995, LB 68, § 1.
NE Code § 44-786 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-786 - Obstetricians/gynecologists as primary care physicians; requirements.

44-786.  Obstetricians/gynecologists as primary care physicians; requirements.On or after July 1, 1996, any entity which offers any individual or group sickness and accident insurance policy, subscriber contract, health maintenance organization contract, or hospital, medical, or surgical expense-incurred policy which is delivered, issued for delivery, or renewed in this state shall include obstetricians/gynecologists as primary care physicians if they otherwise qualify as a primary care physician pursuant to the credentialing or recredentialing standards of that entity and they perform all of the functions of a primary care physician according to the terms and conditions of such entity's primary care physician contract.Source  Laws 1996, LB 532, § 1.
NE Code § 44-789 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-789 - Coverage for bone or joint treatment; requirements.

44-789.  Coverage for bone or joint treatment; requirements.Notwithstanding section 44-3,131, no group policy of accident or health insurance, health services plan, or health maintenance organization subscription shall be offered for sale in this state on or after January 1, 2009, unless such policy, plan, subscription, or contract which specifically provides coverage for surgical and nonsurgical treatment involving a bone or joint of the skeletal structure includes the option to provide coverage, for an additional premium and subject to the insurer's standard of insurability, for the reasonable and necessary medical treatment of temporomandibular joint disorder and craniomandibular disorder. The purchaser of the group policy of accident or health insurance, health services plan, or health maintenance organization subscription shall accept or reject the coverage in writing on the application or an amendment thereto for the master group policy of accident or health insurance, health services plan, or health maintenance organization subscription. Benefits may be subject to the same preexisting conditions, limitations, deductibles, copayments, and coinsurance that generally apply to any other sickness. The maximum lifetime benefits for temporomandibular joint disorder and craniomandibular disorder treatment shall be no less than two thousand five hundred dollars. Nothing in this section shall prevent an insurer from including such coverage for temporomandibular joint disorder and craniomandibular disorder as part of a policy's basic coverage instead of offering optional coverage.Source   Laws 1998, LB 1162, § 82;  Laws 2008, LB855, § 5.
NE Code § 44-791 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-791 - Mental health conditions; legislative findings.

44-791.  Mental health conditions; legislative findings.The Legislature finds that mental health conditions affect a significant number of Nebraskans. Mental health conditions, like severe physical injuries or illness, can be life-altering and debilitating in nature. If properly treated and managed by mental health professionals, persons with mental health conditions can and do lead full and productive lives. However, without such treatment or management, many mental health conditions will progressively deteriorate and negatively impact upon a person's livelihood, social relationships, and physical health.The Legislature also finds that many persons with mental health conditions either do not seek treatment or do not complete or maintain such treatment programs. Treatment options are not underutilized due to the scarcity of professional resources or the lack of desire on the part of persons with mental health conditions, but rather treatment has become unaffordable as the result of the rising health care costs combined with a lack of insurance coverage for mental health conditions. The associated societal and monetary costs of providing no treatment or untimely treatment to persons with mental health conditions are great. It is the intent of sections 44-791 to 44-795 that persons with group health insurance plans providing coverage for mental health conditions be provided with a minimum level of coverage.Source Laws 1999, LB 355, § 1.
NE Code § 44-792 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-792 - Mental health conditions; terms, defined.

44-792.  Mental health conditions; terms, defined.For purposes of sections 44-791 to 44-795:(1) Health insurance plan means (a) any group sickness and accident insurance policy, group health maintenance organization contract, or group subscriber contract delivered, issued for delivery, or renewed in this state and (b) any self-funded employee benefit plan to the extent not preempted by federal law. Health insurance plan includes any group policy, group contract, or group plan offered or administered by the state or its political subdivisions. Health insurance plan does not include group policies providing coverage for a specified disease, accident-only coverage, hospital indemnity coverage, disability income coverage, medicare supplement coverage, long-term care coverage, or other limited-benefit coverage. Health insurance plan does not include any policy, contract, or plan covering an employer group that covers fewer than fifteen employees;(2) Mental health condition means any condition or disorder involving mental illness that falls under any of the diagnostic categories listed in the Mental Disorders Section of the International Classification of Disease;(3) Mental health professional means (a) a practicing physician licensed to practice medicine in this state under the Medicine and Surgery Practice Act, (b) a practicing psychologist licensed to engage in the practice of psychology in this state as provided in section 38-3111 or as provided in similar provisions of the Psychology Interjurisdictional Compact, or (c) a practicing mental health professional licensed or certified in this state as provided in the Mental Health Practice Act;(4) Rate, term, or condition means lifetime limits, annual payment limits, and inpatient or outpatient service limits. Rate, term, or condition does not include any deductibles, copayments, or coinsurance; and(5)(a) Serious mental illness means, prior to January 1, 2002, (i) schizophrenia, (ii) schizoaffective disorder, (iii) delusional disorder, (iv) bipolar affective disorder, (v) major depression, and (vi) obsessive compulsive disorder; and(b) Serious mental illness means, on and after January 1, 2002, any mental health condition that current medical science affirms is caused by a biological disorder of the brain and that substantially limits the life activities of the person with the serious mental illness. Serious mental illness includes, but is not limited to (i) schizophrenia, (ii) schizoaffective disorder, (iii) delusional disorder, (iv) bipolar affective disorder, (v) major depression, and (vi) obsessive compulsive disorder.Source  Laws 1999, LB 355, § 2;  Laws 2007, LB463, § 1135;  Laws 2018, LB1034, § 48.  Cross References   Medicine and Surgery Practice Act, see section 38-2001.  Mental Health Practice Act, see section 38-2101.  Psychology Interjurisdictional Compact, see section 38-3901.
NE Code § 44-793 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-793 - Mental health conditions; coverage; requirements.

44-793.  Mental health conditions; coverage; requirements.(1) On or after January 1, 2000, notwithstanding section 44-3,131, any health insurance plan delivered, issued, or renewed in this state (a) if coverage is provided for treatment of mental health conditions other than alcohol or substance abuse, (i) shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to treatment for a serious mental illness than for access to treatment for a physical health condition, (ii) shall not establish any rate, term, or condition that places a greater financial burden on an insured for accessing treatment for a mental health condition using telehealth services as defined in section 44-312, (iii) shall provide, at a minimum, a reimbursement rate for accessing treatment for a mental health condition using telehealth services that is the same as the rate for a comparable treatment provided or supervised in person, and (iv) if an out-of-pocket limit is established for physical health conditions, shall apply such out-of-pocket limit as a single comprehensive out-of-pocket limit for both physical health conditions and mental health conditions, or (b) if no coverage is to be provided for treatment of mental health conditions, shall provide clear and prominent notice of such noncoverage in the plan.(2) If a health insurance plan provides coverage for serious mental illness, the health insurance plan shall cover health care rendered for treatment of serious mental illness (a) by a mental health professional, (b) by a person authorized by the rules and regulations of the Department of Health and Human Services to provide treatment for mental illness, (c) using telehealth services as defined in section 44-312, (d) in a mental health center as defined in section 71-423, or (e) in any other health care facility licensed under the Health Care Facility Licensure Act that provides a program for the treatment of a mental health condition pursuant to a written plan. The issuer of a health insurance plan may require a health care provider under this subsection to enter into a contract as a condition of providing benefits.(3) The Director of Insurance may disapprove any plan that the director determines to be inconsistent with the purposes of this section.Source  Laws 1999, LB 355, § 3;  Laws 2000, LB 819, § 72;  Laws 2007, LB296, § 178;  Laws 2021, LB487, § 1.   Effective Date: August 28, 2021  Cross References  Health Care Facility Licensure Act, see section 71-401.
NE Code § 44-794 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-794 - Mental health conditions; sections; how construed.

44-794.  Mental health conditions; sections; how construed.(1) Sections 44-791 to 44-795 shall not be construed to:(a) Require a health insurance plan to provide coverage for mental health conditions or serious mental illnesses;(b) Require a health insurance plan to provide the same rates, terms, or conditions between treatments for serious mental illnesses and preventative care;(c) Prohibit a health insurance plan from providing separate reimbursement rates and service delivery systems, including, but not limited to, mental health carve-out programs even if the plan does not provide similar options for the treatment of physical health conditions. A health insurance plan provided in compliance with section 44-793 shall not be construed to violate the Managed Care Plan Network Adequacy Act; or(d) Prohibit a health insurance plan from managing the provision of benefits through common methods, including, but not limited to, preadmission screening, prior authorization of services, or other mechanisms designed to limit coverage to services for mental health conditions that are deemed to be medically necessary and clinically appropriate.(2) A health insurance plan does not violate section 44-793 if the plan applies different rates, terms, and conditions or excludes entirely from coverage the following:(a) Marital, family, educational, developmental, or training services;(b) Care that is substantially custodial in nature;(c) Services and supplies that are not medically necessary or clinically appropriate; or(d) Experimental treatments.(3) A health insurance plan may use a case management program or managed care organization to evaluate, determine, and provide or arrange for medically necessary and clinically appropriate care and treatment of each person with a mental health condition or serious mental illness who is covered by the plan.(4) A health insurance plan shall not be required to offer coverage for nonemergency services rendered outside its network of contracted providers.Source Laws 1999, LB 355, § 4. Cross References  Managed Care Plan Network Adequacy Act, see section 44-7101.
NE Code § 44-795 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-795 - Mental health conditions; rules and regulations.

44-795.  Mental health conditions; rules and regulations.The Director of Insurance may adopt and promulgate rules and regulations to carry out sections 44-791 to 44-795.Source Laws 1999, LB 355, § 5.