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 2024, Nebraska looked at a number of bills addressing prescription drug affordability, including considering PBM and 340b legislation.
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 1087 – Nebraska
Introduced: 2024 Status: In Process
Adopt the Hospital Quality Assurance and Access Assessment Act
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 …
Neb. Rev. Stat. § 44-5266. Small employer carrier; market health benefit plan coverage; carrier, agent, or broker; prohibited activities; compensation to agent or broker; denial of application; rules and regulations; unfair trade practice; when; third-party administrator: Small Employer Health Insurance Availability Act – Nebraska
Introduced: Status: Enacted
Each small employer carrier shall actively market health benefit plan coverage, including the basic health benefit plans and standard health benefit plans, to eligible small employers in the state. If a small employer carrier denies …
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Neb. Rev. Stat. § 44-6916. Health carrier; health benefit plan; restrictions; duties; preexisting condition exclusion; late enrollee; when: Group Health Plans – Nebraska
Introduced: Status: Enacted
Group health plans must treat members of the group the same. This section also sets out limitations on preexisting condition exclusions, such as for pregnant women and recently adopted children.
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Neb. Rev. Stat. § 44-7,107. Telehealth; coverage: General Provisions Covering Life, Sickness, and Accident Insurance – Nebraska
Introduced: Status: Enacted
An insurer shall not exclude service from coverage solely because the service is delivered through telehealth as defined in section 44-312 and is not provided through in-person consultation or contact between a licensed health care …
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Neb. Rev. Stat. § 44-710. Sickness and accident insurance policy; form; approval; exception; premium rates and classification of risks; filing requirements: General Provisions Covering Life, Sickness, and Accident Insurance – Nebraska
Introduced: Status: Enacted
No insurance policies governed by the PPACA or other laws defined by this section may be issued until a copy of the form and of the premium rates and of the classification of risks pertaining …
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Neb. Rev. Stat. § 44-712. Sickness and accident insurance; good faith estimate; requirements; effect: General Provisions Covering Life, Sickness, and Accident Insurance – Nebraska
Introduced: Status: Enacted
An insurer that provides for payment of claims based upon a specific methodology shall provide upon request a written statement that includes a good faith estimate of the dollar amount of the allowable benefit for …
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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. Agency requests are submitted to the Governor by September 15. On or before January 15, the Governor submits a proposed budget to the Nebraska State Senate. The deadline is February 1 for newly elected governors. The Senate adopts a budget in May.
STATE LEGISLATURE
The Nebraska legislature is unique, having a Senate, but no lower chamber, and no political parties are recognized within the Senate. The 49 Senators serve four-year terms. Sessions of the Nebraska Legislature last for 90 working days in odd-numbered years and 60 working days in even-numbered years. The Legislature convenes annually on the first Wednesday after the first Monday in January. Bills carry over from odd to even numbered years.