reglab/housing_qa huggingface dataset:
NE Code § 68-914 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-914 - Application for medical assistance; form; department; decision; notice; requirements; appeal.

68-914.  Application for medical assistance; form; department; decision; notice; requirements; appeal.(1) An applicant for medical assistance shall file an application with the department in a manner and form prescribed by the department. The department shall process each application to determine whether the applicant is eligible for medical assistance. The department shall provide a determination of eligibility for medical assistance in a timely manner in compliance with 42 C.F.R. 435.911, including, but not limited to, a timely determination of eligibility for coverage of an emergency medical condition, such as labor and delivery.(2) The department shall notify an applicant for or recipient of medical assistance of any decision of the department to deny or discontinue eligibility or to deny or modify medical assistance. Except in the case of an emergency, the notice shall be mailed on the same day as or the day after the decision is made. In addition to mailing the notice, the department may also deliver the notice by any form of electronic communication if the department has the agreement of the recipient to receive such notice by means of such form of electronic communication. Decisions of the department, including the failure of the department to act with reasonable promptness, may be appealed, and the appeal shall be in accordance with the Administrative Procedure Act.(3) Notice of a decision to discontinue eligibility or to modify medical assistance shall include an explanation of the proposed action, the reason for the proposed action, the information used to make the decision including specific regulations or laws requiring such action, contact information for personnel of the department to address questions regarding the action, information on the right to appeal, and an explanation of the availability of continued benefits pending such appeal.Source  Laws 2006, LB 1248, § 14;  Laws 2011, LB494, § 1;  Laws 2020, LB956, § 3.  Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 68-916 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-916 - Medical assistance; application; assignment of rights; exception.

68-916.  Medical assistance; application; assignment of rights; exception.The application for medical assistance shall constitute an automatic assignment of the rights specified in this section to the department or its assigns effective from the date of eligibility for such assistance. The assignment shall include the rights of the applicant or recipient and also the rights of any other member of the assistance group for whom the applicant or recipient can legally make an assignment.Pursuant to this section and subject to sections 68-921 to 68-925, the applicant or recipient shall assign to the department or its assigns any rights to medical care support available to him or her or to other members of the assistance group under an order of a court or administrative agency and any rights to pursue or receive payments from any third party liable to pay for the cost of medical care and services arising out of injury, disease, or disability of the applicant or recipient or other members of the assistance group which otherwise would be covered by medical assistance. Medicare benefits shall not be assigned pursuant to this section. Rights assigned to the department or its assigns under this section may be directly reimbursable to the department or its assigns by liable third parties, as provided by rule or regulation of the department, when prior notification of the assignment has been made to the liable third party.Source   Laws 1984, LB 723, § 1;   Laws 1988, LB 419, § 15;   Laws 1989, LB 362, § 10;   Laws 1996, LB 1044, § 326;   Laws 1996, LB 1155, § 23;   R.S.1943, (2003), § 68-1026;  Laws 2006, LB 1248, § 16.  Annotations The statutory assignment to Department of Social Services under this section is subject to a valid hospital lien acquired under section 52-401 when the hospital lien exists before the department obligates itself to pay, or does pay, medical assistance benefits under this section. Ehlers v. Perry, 242 Neb. 208, 494 N.W.2d 325 (1993).
NE Code § 68-917 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-917 - Applicant or recipient; failure to cooperate; effect.

68-917.  Applicant or recipient; failure to cooperate; effect.Refusal by the applicant or recipient specified in section 68-916 to cooperate in obtaining reimbursement for medical care or services provided to himself or herself or any other member of the assistance group renders the applicant or recipient ineligible for assistance. Ineligibility shall continue for so long as such person refuses to cooperate. Cooperation may be waived by the department upon a determination of the reasonable likelihood of physical or emotional harm to the applicant, recipient, or other member of the assistance group if the applicant or recipient were to cooperate. Eligibility shall continue for any individual who cannot legally assign his or her own rights and who would have been eligible for assistance but for the refusal by another person, legally able to assign such individual's rights, to cooperate as required by this section.Source   Laws 1984, LB 723, § 2;   Laws 1997, LB 307, § 108;   R.S.1943, (2003), § 68-1027;  Laws 2006, LB 1248, § 17.
NE Code § 68-918 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-918 - Restoration of rights; when.

68-918.  Restoration of rights; when.If the applicant or recipient or any member of the assistance group becomes ineligible for medical assistance, the department shall restore to him or her the rights assigned under section 68-916.Source   Laws 1984, LB 723, § 3;   Laws 1997, LB 307, § 109;   R.S.1943, (2003), § 68-1028;  Laws 2006, LB 1248, § 18.
NE Code § 68-920 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-920 - Department; garnish employment income; when; limitation.

68-920.  Department; garnish employment income; when; limitation.The department may garnish the wages, salary, or other employment income of a person for the costs of health services provided to a child who is eligible for medical assistance pursuant to the medical assistance program if:(1) The person is required by court or administrative order to provide health care coverage for the costs of such services; and(2) The person has received payment from a third party for the costs of such services but has not used the payment to reimburse either the other parent or guardian or the provider of such services.The amount garnished shall be limited to the amount necessary to reimburse the department for its expenditures for the costs of such services under the medical assistance program. Any claim for current or past-due child support shall take priority over a claim for the costs of health services.Source   Laws 1994, LB 1224, § 71;   Laws 1996, LB 1044, § 335;   R.S.1943, (2003), § 68-1036.03;  Laws 2006, LB 1248, § 20.
NE Code § 68-921 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-921 - Entitlement of spouse; terms, defined.

68-921.  Entitlement of spouse; terms, defined.For purposes of sections 68-921 to 68-925:(1) Assets means property which is not exempt from consideration in determining eligibility for medical assistance under rules and regulations adopted and promulgated under section 68-922;(2) Community spouse monthly income allowance means the amount of income determined by the department in accordance with section 1924 of the federal Social Security Act, as amended, Public Law 100-360, 42 U.S.C. 1396r-5;(3) Community spouse resource allowance means the amount of assets determined in accordance with section 1924 of the federal Social Security Act, as amended, Public Law 100-360, 42 U.S.C. 1396r-5. For purposes of 42 U.S.C. 1396r-5(f)(2)(A)(i), the amount specified by the state shall be twelve thousand dollars;(4) Home and community-based services means services furnished under home and community-based waivers as defined in Title XIX of the federal Social Security Act, as amended, 42 U.S.C. 1396;(5) Qualified applicant means a person (a) who applies for medical assistance on or after July 9, 1988, (b) who is under care in a state-licensed hospital, a nursing facility, an intermediate care facility for persons with developmental disabilities, an assisted-living facility, or a center for the developmentally disabled, as such terms are defined in the Health Care Facility Licensure Act, or an adult family home certified by the department or is receiving home and community-based services, and (c) whose spouse is not under such care or receiving such services and is not applying for or receiving medical assistance;(6) Qualified recipient means a person (a) who has applied for medical assistance before July 9, 1988, and is eligible for such assistance, (b) who is under care in a facility certified to receive medical assistance funds or is receiving home and community-based services, and (c) whose spouse is not under such care or receiving such services and is not applying for or receiving medical assistance; and(7) Spouse means the spouse of a qualified applicant or qualified recipient.Source   Laws 1988, LB 419, § 1;   Laws 1989, LB 362, § 11;   Laws 1991, LB 244, § 1;   Laws 1996, LB 1044, § 336;   Laws 1997, LB 608, § 4;  Laws 2000, LB 819, § 81;   R.S.1943, (2003), § 68-1038;  Laws 2006, LB 1248, § 21;  Laws 2007, LB185, § 3;  Laws 2007, LB296, § 250;  Laws 2013, LB23, § 14. Cross References  Health Care Facility Licensure Act, see section 71-401.
NE Code § 68-922 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-922 - Amount of entitlement; department; rules and regulations.

68-922.  Amount of entitlement; department; rules and regulations.For purposes of determining medical assistance eligibility and the right to and obligation of medical support pursuant to sections 68-716, 68-915, and 68-916, a spouse may retain (1) assets equivalent to the community spouse resource allowance and (2) an amount of income equivalent to the community spouse monthly income allowance.The department shall administer this section in accordance with section 1924 of the Social Security Act, as amended, Public Law 100-360, 42 U.S.C. 1396r-5, and shall adopt and promulgate rules and regulations as necessary to implement and enforce sections 68-921 to 68-925.Source   Laws 1988, LB 419, § 2;   Laws 1989, LB 362, § 12;   R.S.1943, (2003), § 68-1039;  Laws 2006, LB 1248, § 22;  Laws 2007, LB296, § 251.
NE Code § 68-923 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-923 - Assets; eligibility for assistance; future medical support; considerations; subrogation.

68-923.  Assets; eligibility for assistance; future medical support; considerations; subrogation.If a portion of the aggregate assets is designated in accordance with section 68-924:(1) Only the assets not designated for the spouse shall be considered in determining the eligibility of an applicant for medical assistance;(2) In determining the eligibility of an applicant, the assets designated for the spouse shall not be taken into account and proof of adequate consideration for any assignment or transfer made as a result of the designation of assets shall not be required;(3) The assets designated for the spouse shall not be considered to be available to an applicant or recipient for future medical support and the spouse shall have no duty of future medical support of the applicant or recipient from such assets;(4) Recovery may not be made from the assets designated for the spouse for any amount paid for future medical assistance provided to the applicant or recipient; and(5) Neither the department nor the state shall be subrogated to or assigned any future right of the applicant or recipient to medical support from the assets designated for the spouse.Source   Laws 1988, LB 419, § 3;   Laws 1989, LB 362, § 13;   R.S.1943, (2003), § 68-1040;  Laws 2006, LB 1248, § 23;  Laws 2007, LB296, § 252.
NE Code § 68-924 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-924 - Designation of assets; procedure.

68-924.  Designation of assets; procedure.A designation of assets pursuant to section 68-922 shall be evidenced by a written statement listing such assets and signed by the spouse. A copy of such statement shall be provided to the department at the time of application and shall designate assets owned as of the date of application. Failure to complete any assignments or transfers necessary to place the designated assets in sole ownership of the spouse within a reasonable time after the statement is signed as provided in rules and regulations adopted and promulgated under section 68-922 may render the applicant or recipient ineligible for assistance in accordance with such rules and regulations.Source   Laws 1988, LB 419, § 5;   Laws 1989, LB 362, § 14;   R.S.1943, (2003), § 68-1042;  Laws 2006, LB 1248, § 24;  Laws 2007, LB296, § 253.
NE Code § 68-925 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-925 - Department; furnish statement.

68-925.  Department; furnish statement.The department shall furnish to each qualified applicant for and each qualified recipient of medical assistance a clear and simple written statement explaining the provisions of section 68-922.Source   Laws 1988, LB 419, § 6;   Laws 1989, LB 362, § 15;   Laws 1996, LB 1044, § 337;   R.S.1943, (2003), § 68-1043;  Laws 2006, LB 1248, § 25;  Laws 2007, LB296, § 254.
NE Code § 68-926 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-926 - Legislative findings.

68-926.  Legislative findings.The Legislature finds that (1) the department relies on health insurance and claims information from private insurers to ensure accuracy in processing state benefit program payments to providers and in verifying individual recipients' eligibility, (2) delay or refusal to provide such information causes unnecessary expenditures of state funds, (3) disclosure of such information to the department is permitted pursuant to the federal Health Insurance Portability and Accountability privacy rules under 45 C.F.R. part 164, and (4) for medical assistance program recipients who also have other insurance coverage, including coverage by licensed and self-funded insurers, the department is required by 42 U.S.C. 1396a(a)(25) to assure that licensed and self-funded insurers coordinate benefits with the program.Source  Laws 2005, LB 589, § 1;   R.S.Supp.,2005, § 68-10,100;  Laws 2006, LB 1248, § 26;  Laws 2007, LB296, § 255.
NE Code § 68-927 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-927 - Terms, defined.

68-927.  Terms, defined.For purposes of sections 68-926 to 68-933:(1) Coordinate benefits means:(a) Provide to the department information regarding the licensed insurer's or self-funded insurer's existing coverage for an individual who is eligible for a state benefit program; and(b) Meet payment obligations;(2) Coverage information means health information possessed by a licensed insurer or self-funded insurer that is limited to the following information about an individual:(a) Eligibility for coverage under a health plan;(b) Coverage of health care under the health plan; or(c) Benefits and payments associated with the health plan;(3) Health plan means any policy of insurance issued by a licensed insurer or any employee benefit plan offered by a self-funded insurer that provides for payment to or on behalf of an individual as a result of an illness, disability, or injury or change in a health condition;(4) Individual means a person covered by a state benefit program, including the medical assistance program, or a person applying for such coverage;(5) Licensed insurer means any insurer, except a self-funded insurer, including a fraternal benefit society, producer, or other person licensed or required to be licensed, authorized or required to be authorized, or registered or required to be registered pursuant to the insurance laws of the state; and(6) Self-funded insurer means any employer or union who or which provides a self-funded employee benefit plan.Source  Laws 2005, LB 589, § 2;   R.S.Supp.,2005, § 68-10,101;  Laws 2006, LB 1248, § 27;  Laws 2007, LB296, § 256.
NE Code § 68-928 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-928 - Licensed insurer or self-funded insurer; provide coverage information.

68-928.  Licensed insurer or self-funded insurer; provide coverage information.(1) Except as provided in subsection (2) of this section, at the request of the department, a licensed insurer or a self-funded insurer shall provide coverage information to the department without an individual's authorization for purposes of:(a) Determining an individual's eligibility for state benefit programs, including the medical assistance program; or(b) Coordinating benefits with state benefit programs.Such information shall be provided within thirty days after the date of request unless good cause is shown. Requests for coverage information shall specify individual recipients for whom information is being requested.(2)(a) Coverage information requested pursuant to subsection (1) of this section regarding a limited benefit policy shall be limited to whether a specified individual has coverage and, if so, a description of that coverage, and such information shall be used solely for the purposes of subdivision (1)(a) of this section.(b) For purposes of this section, limited benefit policy means a policy of insurance issued by a licensed insurer that consists only of one or more, or any combination of the following:(i) Coverage only for accident or disability income insurance, or any combination thereof;(ii) Coverage for specified disease or illness; or(iii) Hospital indemnity or other fixed indemnity insurance.Source  Laws 2005, LB 589, § 3;   R.S.Supp.,2005, § 68-10,102;  Laws 2006, LB 1248, § 28;  Laws 2007, LB296, § 257.
NE Code § 68-929 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-929 - Licensed insurer; violation.

68-929.  Licensed insurer; violation.Any violation of section 68-928 by a licensed insurer shall be subject to the Unfair Insurance Claims Settlement Practices Act.Source  Laws 2005, LB 589, § 4;   R.S.Supp.,2005, § 68-10,103;  Laws 2006, LB 1248, § 29.  Cross References  Unfair Insurance Claims Settlement Practices Act, see section 44-1536.
NE Code § 68-930 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-930 - Self-funded insurer; violation; civil penalty.

68-930.  Self-funded insurer; violation; civil penalty.The department may impose and collect a civil penalty on a self-funded insurer who violates the requirements of section 68-928 if the department finds that the self-funded insurer:(1) Committed the violation flagrantly and in conscious disregard of the requirements; or(2) Has committed violations with such frequency as to indicate a general business practice to engage in that type of conduct.The civil penalty shall not be more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation by the self-funded insurer was committed flagrantly and in conscious disregard of section 68-928, 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.Source  Laws 2005, LB 589, § 5;   R.S.Supp.,2005, § 68-10,104;  Laws 2006, LB 1248, § 30;  Laws 2007, LB296, § 258.
NE Code § 68-931 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-931 - Recovery; authorized.

68-931.  Recovery; authorized.The department is authorized to recover all amounts paid or to be paid to state benefit programs as a result of failure to coordinate benefits by a licensed insurer or a self-funded insurer.Source  Laws 2005, LB 589, § 6;   R.S.Supp.,2005, § 68-10,105;  Laws 2006, LB 1248, § 31;  Laws 2007, LB296, § 259.
NE Code § 68-932 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-932 - Process for resolving violations; appeal.

68-932.  Process for resolving violations; appeal.The department shall establish a process by rule and regulation for resolving any violation by a self-funded insurer of section 68-928 and for assessing the financial penalties contained in section 68-930. Any appeal of an action by the department under such policies shall be in accordance with the Administrative Procedure Act.Source  Laws 2005, LB 589, § 7;   R.S.Supp.,2005, § 68-10,106;  Laws 2006, LB 1248, § 32;  Laws 2007, LB296, § 260. Cross References  Administrative Procedure Act, see section 84-920.
NE Code § 68-933 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-933 - Civil penalties; disposition.

68-933.  Civil penalties; disposition.All money collected as a civil penalty under section 68-929 or 68-930 shall be remitted to the State Treasurer for distribution in accordance with Article VII, section 5, of the Constitution of Nebraska.Source  Laws 2005, LB 589, § 8;   R.S.Supp.,2005, § 68-10,107;  Laws 2006, LB 1248, § 33.
NE Code § 68-934 (2021)
2021 Nebraska Revised Statutes|Chapter 68 - Public Assistance|68-934 - False Medicaid Claims Act; act, how cited.

68-934.  False Medicaid Claims Act; act, how cited.Sections 68-934 to 68-947 shall be known and may be cited as the False Medicaid Claims Act.Source   Laws 1996, LB 1155, § 67;   R.S.1943, (2003), § 68-1037.01;  Laws 2004, LB 1084, § 1;   R.S.Supp.,2004, § 68-1073;  Laws 2006, LB 1248, § 34;  Laws 2009, LB288, § 21.