reglab/housing_qa huggingface dataset:
NE Code § 44-6607 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6607 - Civil penalty; costs; section, how construed.

44-6607.  Civil penalty; costs; section, how construed.(1) A person or entity who is found by a court of competent jurisdiction, pursuant to an action initiated by the Director of Insurance, to have committed a fraudulent insurance act set forth in section 44-6604 is subject to a civil penalty not to exceed five thousand dollars for the first violation, ten thousand dollars for the second violation, and fifteen thousand dollars for each subsequent violation. An action under this section shall be in lieu of a prosecution under section 28-631.(2) Costs and expenses incurred in any investigation or other action arising out of a violation under the Insurance Fraud Act may be sought in any judgment, court decree, or other final result. Any recovered costs, except civil or criminal penalties, shall be deposited by the director in the fund from which the costs were expended. The court may make such additional orders or judgments as may be necessary to restore to any person in interest any compensation which may have been acquired by means of any act prohibited in section 44-6604.(3) This section shall not be construed to prohibit the director and the alleged violator from entering into a written agreement upon commencement of a civil action in which the alleged violator does not admit or deny the charges but consents to payment of the civil penalty. A consent agreement may not be used in a subsequent civil or criminal proceeding relating to any violation of the act.Source  Laws 1995, LB 385, § 7.
NE Code § 44-6608 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6608 - Act, how construed.

44-6608.  Act, how construed.The Insurance Fraud Act does not:(1) Preempt the authority or relieve the duty of any other law enforcement agency to investigate, examine, and prosecute suspected violations of law;(2) Prevent or prohibit a person from voluntarily disclosing any information concerning insurance fraud to any law enforcement agency;(3) Limit any of the powers granted elsewhere by the laws of this state to the Director of Insurance or the Department of Insurance to investigate and examine possible violations of law and to take appropriate action; or(4) Limit any of the powers granted elsewhere by the laws of this state to the Nebraska Workers' Compensation Court to investigate and examine possible violations of law and to take appropriate action.Source  Laws 1995, LB 385, § 8.
NE Code § 44-6701 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6701 - Act, how cited.

44-6701.  Act, how cited.Sections 44-6701 and 44-6702 shall be known and may be cited as the Health Care Purchasing Pool Act.Source   Laws 1995, LB 837, § 5;   Laws 1996, LB 1044, § 259.
NE Code § 44-6702 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6702 - Legislative intent.

44-6702.  Legislative intent.The Legislature recognizes that a pooling mechanism offers the potential to purchase health care at more affordable prices. The Legislature further recognizes that health care purchasing pools do not require that all groups have the same type of health care coverage or benefits and that many options are available.It is the intent of the Legislature to establish a process to determine whether there should be a coordinated purchasing process for some or all publicly sponsored health care coverage in order to reduce costs and to promote the most efficient methods of financing and coordinating health care services. It is also the intent of the Legislature that the process established also determine whether a health care purchasing pool if established should be made available to individuals, small employer groups, and other associations.Source  Laws 1995, LB 837, § 6.
NE Code § 44-6801 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6801 - Transferred to section 44-6825.

44-6801.  Transferred to section 44-6825.
NE Code § 44-6802 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6802 - Transferred to section 44-6826.

44-6802.  Transferred to section 44-6826.
NE Code § 44-6820 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6820 - Transferred to section 44-6828.

44-6820.  Transferred to section 44-6828.
NE Code § 44-6823 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6823 - Transferred to section 44-6829.

44-6823.  Transferred to section 44-6829.
NE Code § 44-6825 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6825 - Act, how cited.

44-6825.  Act, how cited.Sections 44-6825 to 44-6833 shall be known and may be cited as the Managed Care Emergency Services Act.Source   Laws 1997, LB 279, § 1;   R.S.Supp.,1997, § 44-6801;   Laws 1998, LB 1162, § 17.
NE Code § 44-6826 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6826 - Purpose of act.

44-6826.  Purpose of act.The purpose of the Managed Care Emergency Services Act is to establish standards for health carriers that offer managed care plans to provide for access by covered persons to and delivery of emergency services.Source   Laws 1997, LB 279, § 2;   R.S.Supp.,1997, § 44-6802;   Laws 1998, LB 1162, § 18.
NE Code § 44-6828 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6828 - Applicability of act.

44-6828.  Applicability of act.The Managed Care Emergency Services Act applies to all health carriers that offer managed care plans.Source   Laws 1997, LB 279, § 20;   R.S.Supp.,1997, § 44-6820;   Laws 1998, LB 1162, § 20.
NE Code § 44-6829 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6829 - Health carrier; emergency services; how treated.

44-6829.  Health carrier; emergency services; how treated.(1) A health carrier which provides a covered benefit for emergency services is, subject to the terms and conditions of the health benefit plan, responsible for charges for medically necessary emergency services provided to a covered person, including services furnished outside the network and services deemed approved under subsection (2) of this section.(2) If a treating physician or other emergency department personnel who have provided emergency services to a covered person determine that additional medically necessary services are promptly needed by the covered person and they have requested health carrier approval for such services, the health carrier is deemed to have approved the request if the treating physician or other emergency department personnel involved:(a) Has made a reasonable effort to contact the individual at the health carrier authorized to approve such requests and the health carrier has not provided access to that individual; or(b) Has requested authorization from the individual at the health carrier authorized to approve such requests and the individual has not denied authorization within thirty minutes after the time the request was made, unless the health carrier can document that it had made a good faith effort but was unable to reach the emergency physician within thirty minutes after receiving a request for authorization.A request which is deemed approved under this subsection shall be treated as approval for any medically necessary covered benefits that are required to treat the medical condition identified by the treating physician or other emergency department personnel.(3) A health carrier may impose a reasonable copayment for emergency services to deter inappropriate use of services of hospital emergency departments if the copayment is the same without regard to whether the health care provider has a contractual or other arrangement with the health carrier.Source   Laws 1997, LB 279, § 23;   R.S.Supp.,1997, § 44-6823;   Laws 1998, LB 1162, § 21.
NE Code § 44-6830 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6830 - Health carrier violation; notice; hearing.

44-6830.  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 Managed Care Emergency Services 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, § 22.
NE Code § 44-6831 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6831 - Violation; penalty.

44-6831.  Violation; penalty.If, after the hearing, the director finds a health carrier has violated the Managed Care Emergency Services 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 Managed Care Emergency Services 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, § 23.
NE Code § 44-6832 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6832 - Violation of cease and desist order; penalty.

44-6832.  Violation of cease and desist order; penalty.Any health carrier who violates a cease and desist order of the director under section 44-6831 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, § 24.
NE Code § 44-6833 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6833 - Rules and regulations.

44-6833.  Rules and regulations.The director may adopt and promulgate rules and regulations to carry out the Managed Care Emergency Services Act.Source  Laws 1998, LB 1162, § 25.
NE Code § 44-6834 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6834 - Act, how cited.

44-6834.  Act, how cited.Sections 44-6834 to 44-6850 shall be known and may be cited as the Out-of-Network Emergency Medical Care Act.Source Laws 2020, LB997, § 1.
NE Code § 44-6835 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6835 - Definitions, where found.

44-6835.  Definitions, where found.For purposes of the Out-of-Network Emergency Medical Care Act, the definitions found in sections 44-6836 to 44-6846 apply.Source Laws 2020, LB997, § 2.
NE Code § 44-6836 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6836 - Covered person, defined.

44-6836.  Covered person, defined.Covered person means a person on whose behalf an insurer is obligated to pay health care expense benefits or provide health care services.Source Laws 2020, LB997, § 3.
NE Code § 44-6837 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6837 - Emergency medical condition, defined.

44-6837.  Emergency medical condition, defined.Emergency medical condition means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including, but not limited to, severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (1) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such persons or others in serious jeopardy, (2) serious impairment to such person's bodily functions, (3) serious impairment of any bodily organ or part of such person, or (4) serious disfigurement of such person.Source Laws 2020, LB997, § 4.
NE Code § 44-6838 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6838 - Emergency services, defined.

44-6838.  Emergency services, defined.Emergency services means health care services medically necessary to screen and stabilize a covered person in connection with an emergency medical condition.Source Laws 2020, LB997, § 5.
NE Code § 44-6839 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6839 - Health benefits plan, defined.

44-6839.  Health benefits plan, defined.(1) Health benefits plan means a benefits plan which pays or provides hospital and medical expense benefits for covered services and is delivered or issued for delivery in this state by or through an insurer.(2) Health benefits plan does not include the medical assistance program, medicare, medicare advantage, accident-only, credit, disability, or long-term care coverage, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance, and hospital confinement indemnity coverage.Source Laws 2020, LB997, § 6.
NE Code § 44-6840 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6840 - Health care facility, defined.

44-6840.  Health care facility, defined.Health care facility means a general acute hospital, satellite emergency department, or ambulatory surgical center licensed pursuant to the Health Care Facility Licensure Act.Source Laws 2020, LB997, § 7. Cross References  Health Care Facility Licensure Act, see section 71-401.
NE Code § 44-6841 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6841 - Health care professional, defined.

44-6841.  Health care professional, defined.Health care professional means an individual who is credentialed pursuant to the Uniform Credentialing Act, who is acting within the scope of his or her credential, and who provides a covered service defined by the health benefits plan.Source Laws 2020, LB997, § 8. Cross References  Uniform Credentialing Act, see section 38-101.
NE Code § 44-6842 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6842 - Health care provider, defined.

44-6842.  Health care provider, defined.Health care provider means a health care professional or health care facility.Source Laws 2020, LB997, § 9.
NE Code § 44-6843 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6843 - Insurer, defined.

44-6843.  Insurer, defined.Insurer means an entity that contracts to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits plan, including (1) 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 a policy that provides coverage for a specified disease or other limited-benefit coverage, and (2) any self-funded employee benefit plan to the extent not preempted by federal law.Source Laws 2020, LB997, § 10.
NE Code § 44-6844 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6844 - Medical assistance program, defined.

44-6844.  Medical assistance program, defined.Medical assistance program means the medical assistance program established pursuant to the Medical Assistance Act.Source Laws 2020, LB997, § 11. Cross References  Medical Assistance Act, see section 68-901.
NE Code § 44-6845 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6845 - Medically necessary, defined.

44-6845.  Medically necessary, defined.Medically necessary means a health care service that a health care provider, exercising his or her prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing, or treating an illness, an injury, or a disease, or its symptoms, and that is in accordance with the generally accepted standards of medical practice; that is clinically appropriate, in terms of type, frequency, extent, site, and duration, and considered effective for the covered person's illness, injury, or disease; that is not primarily for the convenience of the covered person or the health care provider; and that is not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that covered person's illness, injury, or disease.Source Laws 2020, LB997, § 12.
NE Code § 44-6846 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6846 - TRICARE, defined.

44-6846.  TRICARE, defined.TRICARE means a health care program of the United States Department of Defense Military Health System.Source Laws 2020, LB997, § 13.
NE Code § 44-6847 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6847 - Emergency services; facility, bill; limitation.

44-6847.  Emergency services; facility, bill; limitation.If a covered person receives emergency services at any health care facility, the facility shall not bill the covered person in excess of any deductible, copayment, or coinsurance amount applicable to in-network services pursuant to the covered person's health benefits plan.Source Laws 2020, LB997, § 14.
NE Code § 44-6848 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6848 - Emergency services; health care provider, bill; limitation.

44-6848.  Emergency services; health care provider, bill; limitation.If a covered person receives emergency services at an in-network or out-of-network health care facility, the health care provider performing those services shall not bill the covered person in excess of any deductible, copayment, or coinsurance amount applicable to in-network services pursuant to the covered person's health benefits plan.Source Laws 2020, LB997, § 15.
NE Code § 44-6849 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6849 - Emergency services; insurer; duties; payment; presumed reasonable; dispute resolution procedure.

44-6849.  Emergency services; insurer; duties; payment; presumed reasonable; dispute resolution procedure.(1) If a covered person receives emergency services at an in-network or out-of-network health care facility, the insurer shall ensure that the covered person incurs no greater out-of-pocket costs than the covered person would have incurred with an in-network health care provider for covered services.(2) With respect to emergency services at an in-network or out-of-network health care facility, if the out-of-network health care provider bills an insurer directly, any reimbursement paid by the insurer shall be paid directly to the out-of-network health care provider. The insurer shall provide the out-of-network health care provider with a written remittance of payment that specifies the proposed reimbursement and the applicable deductible, copayment, or coinsurance amounts owed by the covered person.(3) If emergency services provided at an in-network or out-of-network health care facility are performed, the out-of-network health care provider may bill the insurer for the services rendered. The insurer may pay the billed amount. A claim or a payment shall be presumed reasonable if it is based on the higher of (a) the contracted rate under any then-existing in-network contractual relationship between the insurer and the out-of-network health care provider for the same or similar services or (b) one hundred seventy-five percent of the payment rate for medicare services received from the federal Centers for Medicare and Medicaid Services for the same or similar services in the same geographic area. If the out-of-network health care provider deems the payment made by the insurer unreasonable, the out-of-network health care provider shall return payment to the insurer and utilize the dispute resolution procedure under section 44-6850.Source Laws 2020, LB997, § 16.
NE Code § 44-6850 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6850 - Settlement, negotiation; mediation, when.

44-6850.  Settlement, negotiation; mediation, when.(1) If an insurer or an out-of-network health care provider provides notification that it considers a claim or payment to be not reasonable, the insurer and the health care provider shall have thirty days after the date of such notification to negotiate a settlement. If a settlement has not been reached after such thirty-day period, the insurer and the health care provider shall engage in mediation in accordance with the Uniform Mediation Act. The insurer may attempt to negotiate a final reimbursement amount with the out-of-network health care provider which differs from the amount paid by the insurer pursuant to this section.(2) Following completion of the mediation process, the cost of mediation shall be split evenly and paid by the insurer and the health care provider.(3) Mediation shall not be used when the insurer and the health care provider agree to a separate payment arrangement.Source Laws 2020, LB997, § 17. Cross References  Uniform Mediation Act, see section 25-2930.
NE Code § 44-6901 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6901 - Definitions, where found.

44-6901.  Definitions, where found.For purposes of sections 44-6901 to 44-6918, the definitions found in sections 44-6902 to 44-6915.01 shall be used.Source   Laws 1997, LB 862, § 1;  Laws 2000, LB 1253, § 38;  Laws 2002, LB 1139, § 44.
NE Code § 44-6902 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6902 - Affiliation period, defined.

44-6902.  Affiliation period, defined.Affiliation period means a period which, under the terms of the health insurance coverage offered by a health maintenance organization, must expire before the health insurance coverage becomes effective.Source  Laws 1997, LB 862, § 2.
NE Code § 44-6903 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6903 - Church plan, defined.

44-6903.  Church plan, defined.Church plan means a plan as defined under 29 U.S.C. 1002.Source  Laws 1997, LB 862, § 3.
NE Code § 44-6904 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-6904 - Creditable coverage, defined.

44-6904.  Creditable coverage, defined.(1) Creditable coverage means, with respect to an individual, coverage of the individual under any of the following:(a) A group health plan;(b) Health insurance coverage;(c) Part A or Part B of Title XVIII of the Social Security Act;(d) Title XIX of the Social Security Act, 42 U.S.C. 1396 et seq., other than coverage consisting solely of benefits under section 1928 of the act, 42 U.S.C. 1396s;(e) 10 U.S.C. chapter 55, as such chapter existed on January 1, 2003;(f) A medical care program of the Indian Health Service or of a tribal organization;(g) A state health benefits risk pool;(h) A health plan offered under 5 U.S.C. 8901 et seq.;(i) A public health plan as defined under regulations promulgated by the federal Secretary of Health and Human Services; and(j) A health benefit plan under 22 U.S.C. 2504.(2) Creditable coverage shall not include any coverage that occurs before a significant break in coverage. For purposes of this section, a significant break in coverage shall mean any period of sixty-three consecutive days during all of which the individual does not have any creditable coverage, except that neither a waiting period nor an affiliation period shall be taken into account in determining a significant break in coverage.(3) Creditable coverage shall not include coverage consisting solely of coverage of excepted benefits as that term is defined in the federal Health Insurance Portability and Accountability Act of 1996, 29 U.S.C. 1191b, and regulations adopted pursuant to the act and in effect on April 19, 1998.Source   Laws 1997, LB 862, § 4;   Laws 1998, LB 1035, § 13;  Laws 2003, LB 6, § 4.