Overview
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 a written estimate of average charges for health care services, which promotes transparency and facilitates price shopping. The Nebraska Right to Shop Act, enacted as part of the Direct Primary Care Pilot Program Act, requires participating insurers to make price information public, including out-of-pocket costs. The law also requires insurance carriers to provide financial incentives such as cash from shared savings to patients who choose lower cost, higher quality providers, empowering patients to choose the best value care.
Though the state has not created an all-payer claims database, the 2014 Health Care Transparency Act jumpstarted efforts with an advisory committee that would investigate the creation of an APCD, including how to facilitate the reporting of health care and health quality data, provide for the facilitation of value-based, cost-effective purchasing of health care services by public and private purchasers and consumers, and provisions regarding claims and eligibility standards.
For greater prescription drug pricing transparency, the legislature also enacted the Pharmacy Benefit Fairness and Transparency Act, putting transparency provisions in place for pharmacy benefit managers when contracting with pharmacies and prohibiting clawbacks and gag clauses.
In addition to promoting price transparency, Nebraska monitors consolidation and competition in the healthcare market by requiring nonprofit entities to provide notice to the state attorney general and health agency prior to a merger or acquisition. Applications for such transactions are subject to review and approval by the Nevada Department of Health and Human Services and in some cases, the AG. In the interest of controlling healthcare costs and ensuring continued access to care, the review is based on whether the merger or acquisition is in the public interest.
In telemedicine, Nebraska passed a law in 2017 requiring private payers to cover telemedicine services. While the laws contains a telehealth coverage provision, it does not require payment parity for telehealth services.
See below for an overview of existing Nebraska state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/4/2023 - 6/9/2023 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
LB 100 – Nebraska
Introduced: 2021 Status: Enacted
Prohibit certain billing practices under the Medical Assistance Act. This bill prohibits Medicaid from using a Medicare reimbursement methodology for certain therapies: physical, occupational and speech-pathology that pays the highest rate for the first unit …
LB 1093 – Nebraska
Introduced: 2018 Status: Inactive / Dead
CREATE THE OFFICE OF INSPECTOR GENERAL OF NEBRASKA PUBLIC HEALTH: LB1093 would establish the office of the Inspector General of Nebraska Public Health within the Office of Public Counsel in order to conduct reviews of …
LB 1119 – Nebraska
Introduced: 2018 Status: Enacted
DIRECT PRIMARY CARE PILOT PROGRAM ACT: This Act establishes a direct primary care pilot program within the Nebraska State Insurance Program. The NE Department of Administrative Services shall provide at least two different direct primary …
LB 1175 – Nebraska
Introduced: 2022 Status: Inactive / Dead
Prohibit a health insurer from removing a provider as an in-network provider under certain circumstances. A health insurer in this state shall not remove a provider as an in-network provider for only financial reasons if …
LB 1182 – Nebraska
Introduced: 2020 Status: Inactive / Dead
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 …
LB 29 – Nebraska
Introduced: 2019 Status: Enacted
Provide and eliminate telehealth provisions: LB29 amends the Uniform Credentialing Act to establish provider-patient relationships through telehealth without the requirement for an initial face-to-face visit. It will provide certainty and stability to telehealth providers by …
LB 316 – Nebraska
Introduced: 2019 Status: Enacted
Adopt the Pharmacy Benefit Fairness and Transparency Act: requires that all pharmacy benefit managers (PBMs) doing business in Nebraska obtain certification as a Third Party Administrator under the Third Party Administrator Act, with oversight by …
LB 468 – Nebraska
Introduced: 2019 Status: Enacted
Prohibit inclusion of long-term services and supports under the medicaid managed care program and provide duties for the Department of Health and Human Services and the Department of Insurance. Requires that no additional populations or …
Neb. Rev. Stat. § 21-2219. Merger or consolidation: Professional Corporations – Nebraska
Introduced: Status: Enacted
Provision governs mergers or consolidation of a professional corporation.
Download
Neb. Rev. Stat. § 23-3580. Hospital Authorities Act; declaration of purpose: Hospital Authorities Act – Nebraska
Introduced: Status: Enacted
It is hereby further declared as a matter of legislative determination that high interest rates are contributing to rising costs of health care, that techniques of financing health care facilities have changed, that existing financing …
Download
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
The Nebraska state budget operates on a biennium cycle, covering two fiscal years. Nebraska’s fiscal year begins on July 1 and ends on June 30 of the following year. To view Nebraska’s Department of Health and Human Services Budget, click here.
KEY RESOURCES
- Nebraska Legislature
- Nebraska Office of the Attorney General
- Nebraska Department of Insurance
- Nebraska Health Care Database Advisory Committee
- Nebraska Hospital Association Care Compare