Adopt the Step-Therapy Reform Act: When coverage of a prescription drug for the treatment or any medical condition is restricted for use by a health carrier or utilization review organization through the use of a step-therapy protocol, the prescribing health care provider and the covered person shall have access to a clear, readily accessible, and convenient process to request a step-therapy override exception.
Require sharing of information with the designated health information exchange and change provisions related to the Health Information Technology Board
Allow for audio-only telehealth to be used in delivery of behavioral health services, and postpone the written consent requirement to deliver telehealth services. Allow services to originate from any location where the patient is located.
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Nebraska page. Nebraska has advanced several healthcare price transparency initiatives in the state. To protect patients from surprise billing, the legislature enacted the Out-of-Network Emergency Medical Care Act that prohibits providers from billing patients for medical care received from out-of-network providers or facilities in emergency situations. In addition, Nebraska patients have the ability to petition hospitals for [...]
Newly available on the Source: our health policy research team compiled a user-friendly, downloadable Excel spreadsheet of all provider merger review authority for all 50 states, now on the Market Consolidation interactive key issue page. The detailed chart provides clickable citations of all statutes, regulations, and state authority for mergers, acquisitions, conversions, or changes in ownership of healthcare providers. The comprehensive spreadsheet allows side-by-side comparisons of the level of legal authority for each state to receive notice of impending transactions, review those transactions, and approve, conditionally approve, or disapprove them. It is conveniently organized [...]
LB 997 adopts the Out-of-Network Emergency Medical Care Act. The purpose of this bill is to avoid consumers being subjected to "surprise billing" in emergency situations by out-of-network providers or facilities. The act states that if a covered person receives emergency services at an out-of-network healthcare facility, the healthcare provider performing those services shall not charge the covered person more than if the covered person received services at an in-patient network healthcare facility.
LB 1196 creates the Pharmacy Benefit Manager Regulation Act. The Act would add definitions for spread pricing and clean claims and transfers current statutory provisions into the insurance code. The bill will prohibit exclusionary networks, prohibit punishing patients by requiring them to pay higher co-payments for medications dispensed at local pharmacies, prohibits steering patients to mail order or PBM-owned pharmacies, protect pharmacies from being paid below their cost for dispensing medications, and protect patients with meaningful cost-sharing provisions.
LB 1182 will require drug manufacturers to submit notification to the Nebraska Departmentof Health & Human Services within 60 days of receiving an action date from the Food and Drug Administration, that the marketing application for a new drug has been submitted. The bill also empowers state healthcare officials to conduct studies on drugs subject to price increases that may have significant impact on state expenditures.
LB 970 will limit the total out of pocket costs to patients with insulin drug prescriptions to $100 per each 30 day supply, regardless of the amount or type that is needed to fulfill the prescription.
