reglab/statecodes huggingface dataset:
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-949 - Medical assistance program; legislative intent; department; duties.

68-949.
Medical assistance program; legislative intent; department; duties.
(1) It is the intent of the Legislature that the department implement reforms to the medical assistance program such as those contained in the Medicaid Reform Plan, including (a) an incremental expansion of home and community-based services for aged persons and persons with disabilities consistent with such plan, (b) an increase in care coordination or disease management initiatives to better manage medical assistance expenditures on behalf of high-cost recipients with multiple or chronic medical conditions, and (c) other reforms as deemed necessary and appropriate by the department, in consultation with the committee.
(2) The department shall develop recommendations based on a comprehensive analysis of various options available to the state under applicable federal law for the provision of medical assistance to persons with disabilities who are employed, including persons with a medically improved disability, to enhance and replace current eligibility provisions contained in subdivision (8) of section 68-915.
(3) The department shall develop recommendations for further modification or replacement of the defined benefit structure of the medical assistance program. Such recommendations shall be consistent with the public policy in section 68-905 and shall consider the needs and resources of low-income Nebraska residents who are eligible or may become eligible for medical assistance, the experience and outcomes of other states that have developed and implemented such changes, and other relevant factors as determined by the department.
Source
Laws 2006, LB 1248, § 49;
Laws 2007, LB296, § 263;
Laws 2008, LB928, § 16;
Laws 2017, LB417, § 9;
Laws 2017, LB644, § 17.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-951 - Purpose of act.

68-951.
Purpose of act.
The purpose of the Medicaid Prescription Drug Act is to provide appropriate pharmaceutical care to medicaid recipients in a cost-effective manner by requiring the establishment of a preferred drug list and other activities as prescribed. The preferred drug list and other activities mandated by the act shall not be construed to replace, prohibit, or limit other lawful activities of the department not specifically permitted or required by the act.
Source
Laws 2008, LB830, § 3.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-952 - Terms, defined.

68-952.
Terms, defined.
For purposes of the Medicaid Prescription Drug Act:
(1) Labeler means a person or entity that repackages prescription drugs for retail sale and has a labeler code from the federal Food and Drug Administration under 21 C.F.R. 207.20, as such regulation existed on January 1, 2008;
(2) Manufacturer means a manufacturer of prescription drugs as defined in 42 U.S.C. 1396r-8(k)(5), as such section existed on January 1, 2008, including a subsidiary or affiliate of such manufacturer;
(3) Multistate purchasing pool means an entity formed by an agreement between two or more states to negotiate for supplemental rebates on prescription drugs;
(4) Pharmacy benefit manager means a person or entity that negotiates prescription drug price and rebate arrangements with manufacturers or labelers;
(5) Preferred drug list means a list of prescription drugs that may be prescribed for medicaid recipients without prior authorization by the department; and
(6) Prescription drug has the definition found in section 38-2841.
Source
Laws 2008, LB830, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-953 - Preferred drug list; department; establish and maintain; pharmaceutical and therapeutics committee; members; expenses.

68-953.
Preferred drug list; department; establish and maintain; pharmaceutical and therapeutics committee; members; expenses.
(1) No later than July 1, 2010, the department shall establish and maintain a preferred drug list for the medical assistance program. The department shall establish a pharmaceutical and therapeutics committee to advise the department on all matters relating to the establishment and maintenance of such list.
(2) The pharmaceutical and therapeutics committee shall include at least fifteen but no more than twenty members. The committee shall consist of at least (a) eight physicians, (b) four pharmacists, (c) a university professor of pharmacy or a person with a doctoral degree in pharmacology, and (d) two public members. No more than twenty-five percent of the committee shall be state employees.
(3) The physician members of the committee, so far as practicable, shall include physicians practicing in the areas of (a) family medicine, (b) internal medicine, (c) pediatrics, (d) cardiology, (e) psychiatry or neurology, (f) obstetrics or gynecology, (g) endocrinology, and (h) oncology.
(4) Members of the committee shall submit conflict of interest disclosure statements to the department and shall have an ongoing duty to disclose conflicts of interest not included in the original disclosure.
(5) The committee shall elect a chairperson and a vice-chairperson from among its members. Members of the committee shall be reimbursed for expenses as provided in sections 81-1174 to 81-1177.
(6) The department, in consultation with the committee, shall adopt and publish policies and procedures relating to the preferred drug list, including (a) guidelines for the presentation and review of drugs for inclusion on the preferred drug list, (b) the manner and frequency of audits of the preferred drug list for appropriateness of patient care and cost effectiveness, (c) an appeals process for the resolution of disputes, and (d) such other policies and procedures as the department deems necessary and appropriate.
Source
Laws 2008, LB830, § 5;
Laws 2020, LB381, § 54.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-954 - Preferred drug list; considerations; availability of list.

68-954.
Preferred drug list; considerations; availability of list.
(1) The department and the pharmaceutical and therapeutics committee shall consider all therapeutic classes of prescription drugs for inclusion on the preferred drug list, except that antidepressant, antipsychotic, and anticonvulsant prescription drugs shall not be subject to consideration for inclusion on the preferred drug list.
(2)(a) The department shall include a prescription drug on the preferred drug list if the prescription drug is therapeutically equivalent to or superior to a prescription drug on the list and the net cost of the new prescription drug is equal to or less than the net cost of the listed drug, after consideration of applicable rebates or discounts negotiated by the department.
(b) If the department finds that two or more prescription drugs under consideration for inclusion on the preferred drug list are therapeutically equivalent, the department shall include the more cost-effective prescription drug or drugs on the preferred drug list, after consideration of applicable rebates or discounts negotiated by the department.
(3) The department shall maintain an updated preferred drug list in electronic format and shall make the list available to the public on the department's Internet website.
Source
Laws 2008, LB830, § 6.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-955 - Prescription of drug not on preferred drug list; conditions; antidepressant, antipsychotic, or anticonvulsant prescription drug; prior authorization; not required, when.

68-955.
Prescription of drug not on preferred drug list; conditions; antidepressant, antipsychotic, or anticonvulsant prescription drug; prior authorization; not required, when.
(1) Except as otherwise provided in subsection (3) of this section, a health care provider may prescribe a prescription drug not on the preferred drug list to a medicaid recipient if (a) the prescription drug is medically necessary, (b)(i) the provider certifies that the preferred drug has not been therapeutically effective, or with reasonable certainty is not expected to be therapeutically effective, in treating the recipient's condition or (ii) the preferred drug causes or is reasonably expected to cause adverse or harmful reactions in the recipient, and (c) the department authorizes coverage for the prescription drug prior to the dispensing of the drug. The department shall respond to a prior authorization request no later than twenty-four hours after receiving such request.
(2) A health care provider may prescribe a prescription drug not on the preferred drug list to a medicaid recipient without prior authorization by the department or a managed care organization if the provider certifies that (a) the recipient is achieving therapeutic success with a course of antidepressant, antipsychotic, or anticonvulsant medication or medication for human immunodeficiency virus, multiple sclerosis, epilepsy, cancer, or immunosuppressant therapy or (b) the recipient has experienced a prior therapeutic failure with a medication.
(3) Neither the department nor a managed care organization shall require prior authorization for coverage for an antidepressant, antipsychotic, or anticonvulsant prescription drug that is deemed medically necessary by a patient's health care provider for a new or existing medicaid recipient if the medicaid recipient has prior prescription history for the antidepressant, antipsychotic, or anticonvulsant prescription drug within the immediately preceding ninety-day period. A prospective drug utilization review as described in section 38-2869 and applicable federal law for a prescription for an antidepressant, antipsychotic, or anticonvulsant prescription drug for a medicaid recipient with prior prescription history within the immediately preceding ninety-day period shall occur in order to ensure that the prescription for a medicaid recipient is appropriate and is not likely to result in adverse medical results. Use of a pharmaceutical sample is not considered prior prescription history.
Source
Laws 2008, LB830, § 7;
Laws 2020, LB1052, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-956 - Department; duties.

68-956.
Department; duties.
The department shall: (1) Enter into a multistate purchasing pool; (2) negotiate directly with manufacturers or labelers; or (3) contract with a pharmacy benefit manager for negotiated discounts or rebates for all prescription drugs under the medical assistance program in order to achieve the lowest available price for such drugs under such program.
Source
Laws 2008, LB830, § 8.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-962 - Autism Treatment Program Act; act, how cited.

68-962.
Autism Treatment Program Act; act, how cited.
Sections 68-962 to 68-966 shall be known and may be cited as the Autism Treatment Program Act.
Source
Laws 2007, LB482, § 1;
R.S.1943, (2008), § 85-1,138;
Laws 2009, LB27, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-963 - Purpose of Autism Treatment Program Act.

68-963.
Purpose of Autism Treatment Program Act.
The purpose of the Autism Treatment Program Act is to provide for the development and administration of a waiver or an amendment to an existing waiver under the medical assistance program established in section 68-903.
Source
Laws 2007, LB482, § 2;
R.S.1943, (2008), § 85-1,139;
Laws 2009, LB27, § 3.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-964 - Autism Treatment Program; created; administration; funding.

68-964.
Autism Treatment Program; created; administration; funding.
The Autism Treatment Program is created. The program shall be administered by the department.
Source
Laws 2007, LB482, § 3;
R.S.1943, (2008), § 85-1,140;
Laws 2009, LB27, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-965 - Autism Treatment Program Cash Fund; created; use; investment.

68-965.
Autism Treatment Program Cash Fund; created; use; investment.
(1) The Autism Treatment Program Cash Fund is created. The fund shall include revenue received from gifts, grants, bequests, donations, other similar donation arrangements, or other contributions from public or private sources. The department shall administer the fund. The fund shall be used as the state's matching share for the waiver established under section 68-966 and for expenses incurred in the administration of the Autism Treatment Program. Any money in the fund available for investment shall be invested by the state investment officer pursuant to the Nebraska Capital Expansion Act and the Nebraska State Funds Investment Act.
(2) The program shall utilize private funds deposited in the fund. No donations from a provider of services under Title XIX of the federal Social Security Act shall be deposited into the fund.
Source
Laws 2007, LB482, § 4;
R.S.1943, (2008), § 85-1,141;
Laws 2009, LB27, § 5;
Laws 2012, LB969, § 8.
Cross References
Nebraska Capital Expansion Act, see section 72-1269.
Nebraska State Funds Investment Act, see section 72-1260.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-966 - Department; apply for medical assistance program waiver or amendment; legislative intent.

68-966.
Department; apply for medical assistance program waiver or amendment; legislative intent.
(1) The department shall apply for a waiver or an amendment to an existing waiver under the medical assistance program established in section 68-903 for the purpose of providing medical assistance for intensive early intervention services based on behavioral principles for children with a medical diagnosis of an autism spectrum disorder or an educational verification of autism. Such waiver shall not be construed to create an entitlement to services provided under such waiver.
(2) It is the intent of the Legislature that such waiver (a) require means testing for and cost-sharing by recipient families, (b) limit eligibility only to children for whom such services have been initiated prior to the age of nine years, (c) limit the number of children served according to available funding, (d) require demonstrated progress toward the attainment of treatment goals as a condition for continued receipt of medical assistance benefits for such treatment, (e) be developed in consultation with the Health and Human Services Committee of the Legislature and the federal Centers for Medicare and Medicaid Services and with the input of parents and families of children with autism spectrum disorders and organizations advocating on behalf of such persons, and (f) be submitted to the federal Centers for Medicare and Medicaid Services as soon as practicable, but no later than September 1, 2009.
Source
Laws 2007, LB482, § 5;
R.S.1943, (2008), § 85-1,142;
Laws 2009, LB27, § 6.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-967 - Comprehensive treatment of pediatric feeding disorders; amendment to state medicaid plan; department; duties.

68-967.
Comprehensive treatment of pediatric feeding disorders; amendment to state medicaid plan; department; duties.
(1) On or before July 1, 2010, the Department of Health and Human Services shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services amending the state medicaid plan to provide for medicaid payments for the comprehensive treatment of pediatric feeding disorders through interdisciplinary treatment.
(2) For purposes of this section, interdisciplinary treatment means the collaboration of medicine, psychology, nutrition science, speech therapy, occupational therapy, social work, and other appropriate medical and behavioral disciplines in an integrated program.
(3) This section terminates on January 1, 2015, unless extended by action of the Legislature.
Source
Laws 2009, LB342, § 2.
Termination Date: January 1, 2015
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-968 - School-based health centers; School Health Center Advisory Council; members.

68-968.
School-based health centers; School Health Center Advisory Council; members.
(1) To ensure that the interests of the school district, community, and health care provider are reflected within the policies, procedures, and scope of services of school-based health centers, each school district shall establish a School Health Center Advisory Council for each school in the district hosting a school-based health center.
(2) The School Health Center Advisory Council shall include:
(a) At least one representative of the school administration or school district administration;
(b) At least one representative of the sponsoring facility; and
(c) At least one parent recommended by a school administrator or school district administrator and approved by a majority vote of the school board. Any parent serving on a School Health Center Advisory Council shall have at least one child enrolled in the school through which the school-based health center is organized.
(3) If another institution or organization sponsors the school-based health center, at least one representative of each sponsoring institution or organization shall be included on the School Health Center Advisory Council.
(4) School Health Center Advisory Councils may also include students enrolled in the school district through which the school-based health center is organized. Any such students must be appointed by a school administrator or school district administrator.
Source
Laws 2010, LB1106, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-969 - Amendment to medicaid state plan or waiver; children eligible for medicaid and CHIP; treatment for pregnant women; department; duties.

68-969.
Amendment to medicaid state plan or waiver; children eligible for medicaid and CHIP; treatment for pregnant women; department; duties.
(1) On or before July 1, 2010, the department shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services, amending the medicaid state plan or seeking a waiver thereto to provide for utilization of money to allow for payments for treatment for children who are lawfully residing in the United States and who are otherwise eligible for medicaid and CHIP pursuant to the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3, as such act existed on January 1, 2010, and for treatment for pregnant women who are lawfully residing in the United States and who are otherwise eligible for medicaid pursuant to the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3, as such act existed on January 1, 2010.
(2) For purposes of this section, (a) CHIP means the Children's Health Insurance Program established pursuant to 42 U.S.C. 1397aa et seq., and (b) medicaid means the program for medical assistance established under 42 U.S.C. 1396 et seq., as such sections existed on January 1, 2010.
Source
Laws 2010, LB1106, § 5.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-970 - Nebraska Regional Poison Center; legislative findings.

68-970.
Nebraska Regional Poison Center; legislative findings.
The Legislature finds that:
(1) The Nebraska Regional Poison Center funded through the University of Nebraska Medical Center Cash Fund provides a valuable service to Nebraska;
(2) The center receives over seventeen thousand calls annually, seventy-two percent of the calls involve children, and over twenty-seven percent of the calls relate to children in families whose annual household income is at or below two hundred percent of the federal poverty level;
(3) The operation of the center has resulted in over ninety percent of the calls regarding a child under six years of age being handled in a manner such that the child was able to remain at home and the child did not have to visit an emergency room or use 911 or emergency medical services; and
(4) The operation of the center results in a cost savings of one hundred seventy-five dollars per call in 1996 dollars.
Source
Laws 2011, LB525, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-971 - Amendment to medicaid state plan or waiver; Nebraska Regional Poison Center; payments; use; department; duties; University of Nebraska Medical Center; report.

68-971.
Amendment to medicaid state plan or waiver; Nebraska Regional Poison Center; payments; use; department; duties; University of Nebraska Medical Center; report.
(1) On or before January 1, 2012, the department shall submit an application to the federal Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to amend the medicaid state plan or seek a waiver to provide for utilization of the unused administrative cap to allow for payments to the Nebraska Regional Poison Center funded through the University of Nebraska Medical Center Cash Fund to help offset the cost for treatment of children who are eligible for assistance under the medical assistance program and the Children's Health Insurance Program established pursuant to 42 U.S.C. 1397aa et seq., pursuant to the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3, as such act existed on January 1, 2010.
(2) Upon approval of the amendment to the medicaid state plan or the granting of the waiver, the University of Nebraska Medical Center shall transfer an amount, not to exceed two hundred fifty thousand dollars, to the Health and Human Services Cash Fund for the Nebraska Department of Health and Human Services to meet the state match to maximize the use of the unused administrative cap money. At the time the department receives the transferred amount or any portion thereof and the corollary federal funds, the department shall transfer the combined funds to the University of Nebraska Medical Center Cash Fund for operation of the Nebraska Regional Poison Center. If no amendment is approved nor waiver granted or if less than two hundred fifty thousand dollars is needed for the match, then the University of Nebraska Medical Center may use the remaining state appropriation for the operation of the Nebraska Regional Poison Center.
(3) The University of Nebraska Medical Center shall report electronically to the Legislative Fiscal Analyst on or before October 1 of every year the amount transferred to the department in the prior fiscal year and the amount of matching funds received under this section for the Nebraska Regional Poison Center in the prior fiscal year.
Source
Laws 2011, LB525, § 3;
Laws 2012, LB782, § 94.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-973 - Medical assistance programs; improper payments; postpayment reimbursement; legislative findings; integrity procedures and guidelines; legislative intent.

68-973.
Medical assistance programs; improper payments; postpayment reimbursement; legislative findings; integrity procedures and guidelines; legislative intent.
(1) The Legislature finds that the medical assistance program would benefit from increased efforts to (a) prevent improper payments to service providers, including, but not limited to, enforcement of eligibility criteria for recipients of benefits, enforcement of enrollment criteria for providers of benefits, determination of third-party liability for benefits, review of claims for benefits prior to payment, and identification of the extent and cause of improper payment, (b) identify and recoup improper payments, including, but not limited to, identification and investigation of questionable payments for benefits, administrative recoupment of payments for benefits, and referral of cases of fraud to the state medicaid fraud control unit for prosecution, and (c) collect postpayment reimbursement, including, but not limited to, maximizing prescribed drug rebates and maximizing recoveries from estates for paid benefits.
(2) The Legislature further finds that (a) the medical assistance program was established under Title XIX of the federal Social Security Act and is a joint federal-state-funded health insurance program that is the primary source of medical assistance for low-income, disabled, and elderly Nebraskans and (b) the federal government establishes minimum requirements for the medical assistance program and the state designs, implements, administers, and oversees the medical assistance program.
(3) It is the intent of the Legislature to establish and maintain integrity procedures and guidelines for the medical assistance program that meet minimum federal requirements and that coordinate with federal program integrity efforts in order to provide a system that encourages efficient and effective provision of services by Nebraska providers for the medical assistance program.
Source
Laws 2012, LB541, § 2;
Laws 2020, LB956, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-975 - Department; apply for amendment to medicaid state plan; multisystemic therapy for youth.

68-975.
Department; apply for amendment to medicaid state plan; multisystemic therapy for youth.
(1) On or before May 1, 2016, the department shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to amend the medicaid state plan to provide for utilization of money to allow for payments for multisystemic therapy for youth who are eligible for the medical assistance program and CHIP pursuant to the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3, as such act existed on January 1, 2015.
(2) For purposes of this section, CHIP means the Children's Health Insurance Program established pursuant to 42 U.S.C. 1397aa et seq., as such section existed on January 1, 2015.
Source
Laws 2015, LB500, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-976 - Provider with high categorical risk level; fingerprint-based criminal history record information check; Nebraska State Patrol; issue report; cost; department; powers and duties.

68-976.
Provider with high categorical risk level; fingerprint-based criminal history record information check; Nebraska State Patrol; issue report; cost; department; powers and duties.
(1)(a) Any provider with a high categorical risk level as determined by the Centers for Medicare and Medicaid Services or the medicaid assistance program established pursuant to the Medical Assistance Act shall be subject to a fingerprint-based criminal history record information check.
(b) Such provider who is an individual, or any individual with at least a five percent direct or indirect ownership interest in any such provider, shall provide his or her fingerprints to the Nebraska State Patrol. The Nebraska State Patrol shall undertake a search for fingerprint-based criminal history record information relating to such provider, including transmittal of the fingerprints to the Federal Bureau of Investigation for a national fingerprint-based criminal history record information check.
(c) The fingerprint-based criminal history record information check shall include information concerning the provider from federal repositories of such information and repositories of such information in other states, if authorized by federal law.
(d) The Nebraska State Patrol shall issue a report to the department that includes the fingerprint-based criminal history record information concerning the provider.
(e) The provider or individual being screened shall pay the actual cost of the fingerprinting and fingerprint-based criminal history record information check.
(2) The department shall maintain a record of the results of the fingerprint-based criminal history record information check.
(3) The department may deny or terminate the enrollment of:
(a) Any provider who is an individual who does not pass the national fingerprint-based criminal history record information check; or
(b) Any provider in which an individual with at least a five percent direct or indirect ownership interest in the provider does not pass the national fingerprint-based criminal history record information check. Criteria for not passing the fingerprint-based criminal history record information check includes at least the following: (i) Any criminal conviction within the last ten years related to the provider's involvement with the federal Health Insurance for the Aged Act, 42 U.S.C. 1305 et seq., any program or assistance set forth in Chapter 68, or the federal Children's Health Insurance Program established pursuant to 42 U.S.C. 1397aa, as such act, laws, and section existed on January 1, 2016; or (ii) any conviction involving fraudulent activities.
Source
Laws 2016, LB698, § 16.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-978 - Terms, defined.

68-978.
Terms, defined.
For purposes of the Ground Emergency Medical Transport Act:
(1) Advanced life support means special services designed to provide definitive prehospital emergency medical care, including, but not limited to, cardiopulmonary resuscitation, cardiac monitoring, cardiac defibrillation, advanced airway management, intravenous therapy, administration with drugs and other medicinal preparations, and other specified techniques and procedures;
(2) Basic life support means emergency first aid and cardiopulmonary resuscitation procedures to maintain life without invasive techniques;
(3) Capitation payment means a payment the state makes periodically to a contractor on behalf of each beneficiary enrolled under a contract and based on the actuarially sound capitation rate for the provision of services under the state plan and which the state makes regardless of whether the particular beneficiary receives services during the period covered by the payment;
(4) Dry run means ground emergency medical transport services provided by an eligible ground emergency medical transport services provider to an individual who is released on the scene without transportation by ambulance to a medical facility;
(5) Ground emergency medical transport means the act of transporting an individual from any point of origin to the nearest medical facility capable of meeting the emergency medical needs of the patient, including dry runs;
(6) Ground emergency medical transport services means advanced life support, limited advanced life support, and basic life support services provided to an individual by ground emergency medical transport services providers before or during ground emergency medical transport;
(7) Limited advanced life support means special services to provide prehospital emergency medical care limited to techniques and procedures that exceed basic life support but are less than advanced life support services; and
(8) Medical transport means transportation to secure medical examinations and treatment for an individual.
Source
Laws 2017, LB578, § 3.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-979 - Legislative intent.

68-979.
Legislative intent.
It is the intent of the Legislature that no General Funds be used in carrying out the Ground Emergency Medical Transport Act.
Revenue from the intergovernmental transfer program created under the Ground Emergency Medical Transport Act shall be deposited into the Health and Human Services Cash Fund.
Source
Laws 2017, LB578, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-980 - Supplemental reimbursement.

68-980.
Supplemental reimbursement.
An eligible provider as described in section 68-981 shall, in addition to the rate of payment that the provider would otherwise receive for medicaid ground emergency medical transport services, receive supplemental reimbursement pursuant to the Ground Emergency Medical Transport Act.
Source
Laws 2017, LB578, § 5.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-981 - Supplemental reimbursement; eligibility.

68-981.
Supplemental reimbursement; eligibility.
Participation in the supplemental reimbursement program by an eligible provider is voluntary. A provider is eligible for supplemental reimbursement only if the provider has all of the following characteristics continuously during a fiscal year of the state:
(1) Provides ground emergency medical transport services to medicaid beneficiaries;
(2) Is enrolled as a medicaid provider for the period being claimed;
(3) Is owned or operated by the state or a city, county, rural or suburban fire protection district, hospital district, federally recognized Indian tribe, or another unit of government; and
(4) Participates in the intergovernmental transfer program created pursuant to section 68-983.
Source
Laws 2017, LB578, § 6.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-982 - Supplemental reimbursement; calculation and payment.

68-982.
Supplemental reimbursement; calculation and payment.
(1) An eligible provider's supplemental reimbursement pursuant to the Ground Emergency Medical Transport Act shall be calculated and paid as follows:
(a) The supplemental reimbursement shall equal the amount of federal financial participation received as a result of the claims submitted pursuant to the act; and
(b) In no instance may the amount certified pursuant to section 68-985, when combined with the amount received from all other sources of reimbursement from the medical assistance program, exceed one hundred percent of actual costs, as determined pursuant to the medicaid state plan, for ground emergency medical transport services.
(2) The supplemental reimbursement shall be distributed exclusively to eligible providers under a payment method based on ground emergency medical transport services provided to medicaid beneficiaries by eligible providers on a per-transport basis or other federally permissible basis.
Source
Laws 2017, LB578, § 7.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-984 - Agreement.

68-984.
Agreement.
(1) An eligible provider, as a condition of receiving supplemental reimbursement, shall enter into and maintain an agreement with the department for purposes of implementing the Ground Emergency Medical Transport Act and reimbursing the department for the costs of administering the act.
(2) The nonfederal share of the supplemental reimbursement submitted to the federal Centers for Medicare and Medicaid Services for purposes of claiming federal financial participation shall be paid only with funds from the governmental entities described in subdivision (3) of section 68-981 and certified to the department as provided in section 68-985.
Source
Laws 2017, LB578, § 9.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-985 - Governmental entity; duties.

68-985.
Governmental entity; duties.
If a governmental entity elects to seek supplemental reimbursement pursuant to the Ground Emergency Medical Transport Act on behalf of an eligible provider owned or operated by the entity, the governmental entity shall:
(1) Certify, in conformity with the requirements of 42 C.F.R. 433.51, that the claimed expenditures for ground emergency medical transport services are eligible for federal financial participation;
(2) Provide evidence supporting the certification as specified by the department;
(3) Submit data as specified by the department to determine the appropriate amounts to claim as expenditures qualifying for federal financial participation; and
(4) Keep, maintain, and have readily retrievable any records specified by the department to fully disclose reimbursement amounts to which the eligible provider is entitled and any other records required by the federal Centers for Medicare and Medicaid Services.
Source
Laws 2017, LB578, § 10.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-986 - Department; amendment to medicaid state plan; department; powers.

68-986.
Department; amendment to medicaid state plan; department; powers.
(1) On or before January 1, 2018, the department shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services amending the medicaid state plan to provide for the supplemental reimbursement rate for ground emergency medical transport services as specified in the Ground Emergency Medical Transport Act.
(2) The department may limit the program to those costs that are allowable expenditures under Title XIX of the federal Social Security Act, 42 U.S.C. 1396 et seq., as such act and sections existed on April 1, 2017. Without such federal approval, the Ground Emergency Medical Transport Act may not be implemented.
(3) The intergovernmental transfer program authorized in section 68-983 shall be implemented only if and to the extent federal financial participation is available and is not otherwise jeopardized and any necessary federal approval has been obtained.
(4) To the extent that the chief executive officer of the department determines that the payments made pursuant to section 68-983 do not comply with federal medicaid requirements, the chief executive officer may return or not accept an intergovernmental transfer and may adjust payments as necessary to comply with federal medicaid requirements.
Source
Laws 2017, LB578, § 11.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-987 - Department; duties.

68-987.
Department; duties.
(1) The department shall submit claims for federal financial participation for the expenditures for the services described in section 68-986 that are allowable expenditures under federal law.
(2) The department shall annually submit any necessary materials to the federal government to provide assurances that claims for federal financial participation will include only those expenditures that are allowable under federal law.
(3) If either a final judicial determination is made by any court of appellate jurisdiction or a final determination is made by the administrator of the federal Centers for Medicare and Medicaid Services that the supplemental reimbursement provided for in the act shall be made to any provider not described in this section, the chief executive officer of the department shall execute a declaration stating that the determination has been made and such supplemental reimbursement becomes inoperative on the date of such determination.
Source
Laws 2017, LB578, § 12.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-988 - Increased capitation payments; commencement.

68-988.
Increased capitation payments; commencement.
To the extent federal approval is obtained, the increased capitation payments under section 68-983 may commence for dates of service on or after January 1, 2018.
Source
Laws 2017, LB578, § 13.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-991 - Medical provider; authority to apply for medical assistance.

68-991.
Medical provider; authority to apply for medical assistance.
A medical provider shall have the authority of a guardian and conservator for the limited purpose of making application for medical assistance on behalf of a person whom the provider is treating if the person is unconscious or otherwise is unable to apply for medical assistance and does not have an existing power of attorney or a court-appointed individual to apply on the person’s behalf.
Source
Laws 2017, LB268, § 13.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-992 - Eligibility for medical assistance; expanded population; Department of Health and Human Services; duties.

68-992.
Eligibility for medical assistance; expanded population; Department of Health and Human Services; duties.
(1) Eligibility for medical assistance shall be expanded to include certain adults ages nineteen through sixty-four whose income is equal to or less than one hundred thirty-eight percent of the federal poverty level, as authorized and using the income methodology defined by 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) and related federal regulations and guidance, as such statute, regulations, and guidance existed on January l, 2018.
(2) On or before April 1, 2019, in order to ensure that eligibility for medical assistance is expanded as required by this section, the Department of Health and Human Services shall submit a state plan amendment and all other necessary documents seeking required approvals or waivers to the federal Centers for Medicare and Medicaid Services.
(3) The Department of Health and Human Services shall take all actions necessary to maximize federal financial participation in funding medical assistance pursuant to this section.
(4) No greater or additional burdens or restrictions on eligibility, enrollment, benefits, or access to health care services shall be imposed on persons eligible for medical assistance pursuant to this section than on any other population eligible for medical assistance.
(5) This section shall apply notwithstanding any other provision of law or federal waiver.
Source
Initiative Law 2018, No. 427, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-993 - Medical parole; protocol.

68-993.
Medical parole; protocol.
The Division of Medicaid and Long-Term Care of the Department of Health and Human Services shall, in consultation with the Department of Correctional Services, develop a protocol to assist an individual who is eligible for medical parole pursuant to section 83-1,110.02 to apply for and receive benefits under the Medical Assistance Act.
Source
Laws 2019, LB726, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-994 - Long-term care services and supports; department; limitation on addition to medicaid managed care program.

68-994.
Long-term care services and supports; department; limitation on addition to medicaid managed care program.
Until July 1, 2023, the department shall not add long-term care services and supports to the medicaid managed care program. For purposes of this section, long-term care services and supports includes services of a skilled nursing facility, a nursing facility, and an assisted-living facility and home and community-based services.
Source
Laws 2019, LB468, § 2;
Laws 2021, LB101, § 1.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-995 - Contracts and agreements; department; duties.

68-995.
Contracts and agreements; department; duties.
All contracts and agreements relating to the medical assistance program governing at-risk managed care service delivery for health services entered into by the department and existing on or after August 11, 2020, shall:
(1) Provide a definition and cap on administrative spending such that (a) administrative expenditures do not include profit greater than the contracted amount, (b) any administrative spending is necessary to improve the health status of the population to be served, and (c) administrative expenditures do not include contractor incentives. Administrative spending shall not under any circumstances exceed twelve percent. Such spending shall be tracked by the contractor and reported quarterly to the department and electronically to the Clerk of the Legislature;
(2) Provide a definition of annual contractor profits and losses and restrict such profits and losses under the contract so that profit shall not exceed a percentage specified by the department but not more than three percent per year as a percentage of the aggregate of all income and revenue earned by the contractor and related parties, including parent and subsidiary companies and risk-bearing partners, under the contract;
(3) Provide for return of (a) any remittance if the contractor does not meet the minimum medical loss ratio, (b) any unearned incentive funds, and (c) any other funds in excess of the contractor limitations identified in state or federal statute or contract to the State Treasurer for credit to the Medicaid Managed Care Excess Profit Fund;
(4) Provide for a minimum medical loss ratio of eighty-five percent of the aggregate of all income and revenue earned by the contractor and related parties under the contract;
(5) Provide that contractor incentives, in addition to potential profit, be up to two percent of the aggregate of all income and revenue earned by the contractor and related parties under the contract; and
(6) Be reviewed and awarded competitively and in full compliance with the procurement requirements of the State of Nebraska.
Source
Laws 2012, LB1158, § 2;
Laws 2016, LB1011, § 1;
R.S.1943, (2018), § 71-831;
Laws 2020, LB1158, § 2.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-996 - Medicaid Managed Care Excess Profit Fund; created; use; investment.

68-996.
Medicaid Managed Care Excess Profit Fund; created; use; investment.
The Medicaid Managed Care Excess Profit Fund is created. The fund shall contain money returned to the State Treasurer pursuant to subdivision (3) of section 68-995. The fund shall first be used to offset any losses under subdivision (2) of section 68-995 and then to provide for services addressing the health needs of adults and children under the Medical Assistance Act, including filling service gaps, providing system improvements, and sustaining access to care as determined by the Legislature. The fund shall only be used for the purposes described in this section. Any money in the fund available for investment shall be invested by the state investment officer pursuant to the Nebraska Capital Expansion Act and the Nebraska State Funds Investment Act.
Source
Laws 2020, LB1158, § 3.
Cross References
Nebraska Capital Expansion Act, see section 72-1269.
Nebraska State Funds Investment Act, see section 72-1260.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-997 - Job-skills programs; voluntary; departments; powers and duties.

68-997.
Job-skills programs; voluntary; departments; powers and duties.
(1) Beginning October 1, 2020, the Department of Health and Human Services shall inform each adult applicant for medical assistance about job-skills programs within the Department of Health and Human Services, the Department of Labor, or other skill-based programs that could assist the applicant for medical assistance in obtaining job skills or training, employment, higher-paying jobs, or related skills. The Department of Health and Human Services shall connect interested applicants to such job-skills programs. The job-skills programs may be utilized on a voluntary basis by applicants for medical assistance or recipients of medical assistance. The job-skills programs do not affect the receipt of services provided under the Medical Assistance Act.
(2) Beginning February 1, 2021, and within thirty days of the expiration of each subsequent calendar quarter within the years 2021 and 2022, the Department of Health and Human Services shall report electronically to the Clerk of the Legislature on the total number of applicants for medical assistance who were referred to job-skills programs under this section and any job-skills services received as a result of this section by applicants for medical assistance.
(3) Beginning January 1, 2021, through December 31, 2022, the Department of Labor shall report quarterly to the Department of Health and Human Services the number of applicants for medical assistance who were referred to job-skills programs under this section, the number of applicants for medical assistance who received help obtaining job skills or training, employment, higher-paying jobs, or related skills under this section, and the types of job-skills services received as a result of this section.
(4) The Department of Health and Human Services and the Department of Labor shall administer this section.
Source
Laws 2020, LB1158, § 4.
2023 Nebraska Revised Statutes › Chapter 68 - Public Assistance › 68-999 - Direct care staff; psychiatric facilities caring for juveniles; standards.

68-999.
Direct care staff; psychiatric facilities caring for juveniles; standards.
The Division of Medicaid and Long-Term Care of the Department of Health and Human Services shall set standards required for direct care staff of inpatient psychiatric units for juveniles and psychiatric residential treatment facilities for juveniles. The standards shall require that each such staff member:
(1) Be twenty years of age or older;
(2) Be at least two years older than the oldest resident in the unit or facility;
(3) Have a high school diploma or its equivalent; and
(4) Have appropriate training for basic interaction care such as supervision, daily living care, and mentoring of residents in the unit or facility.
Source
Laws 2020, LB1002, § 44.