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NebraskaLB332109th Legislature 1st and 2nd SessionslegislatureWALLET

Provide for assistant funeral directors, change scope of practice and regulatory provisions regarding funeral directing and embalming, hearing instrument specialists, and audiologists, change membership provisions for the Board of Pharmacy, change provisions regarding delegated dispensing permits and prescription refills, provide medicaid coverage for psychology services, and establish the Rural Health Opportunity Program

Sponsored By: Brian Hardin

Signed by Governor

Health and Human Services Committee

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Bill Overview

Analyzed Economic Effects

17 provisions identified: 9 benefits, 0 costs, 8 mixed.

Full tuition waivers for rural students

The Rural Health Opportunity Program waives 100% of tuition and fees for up to four academic years at a state college. You must be a Nebraska high school graduate or have a Nebraska equivalency and have lived in a rural area as defined by the boards. The waiver covers courses needed for early admission and transfer to eligible programs at the University of Nebraska Medical Center. The Legislature states intent to fund at least half of the waiver costs.

More Medicaid help for devices and support

Starting August 1, 2024, Medicaid covers continuous glucose monitors (CGMs) for people with a prescription, including gestational diabetes and those who meet local coverage rules. By January 1, 2024, Medicaid pays for needed translation and interpreter services during covered care. By January 1, 2025, Medicaid covers an electric personal‑use breast pump beginning at 36 weeks of pregnancy or at birth and at least ten lactation visits per mother (or per child if the mother is not covered). Lawmakers intend to pay lactation visits at a rate 145% higher than the current rate. The state uses the Medicaid Managed Care Excess Profit Fund to support these changes, with $600,000 a year set to implement the CGM expansion.

More Medicaid mental health and postpartum care

By January 1, 2026, Medicaid covers psychology services from advanced trainees who finished a doctoral internship or a postdoctoral fellowship and work under a licensed psychologist. The department seeks federal approval (by October 1, 2023) to extend postpartum coverage from 60 days to at least six months, and it may seek 12 months; coverage starts after federal approval. By October 1, 2025, the state must ask to reimburse medical respite at two facilities—one in a metropolitan‑class city and one in a primary‑class city—for adults who are homeless in the expansion group, funded from the Medicaid Managed Care Excess Profit Fund. These changes increase access but the respite and postpartum extensions require federal approval first.

Clearer hearing aid sales and receipts

Sellers must give a written contract for each hearing aid sale. At delivery, you get an itemized receipt with the seller’s license info; brand, model, and serial; price; software status; whether it is new, used, or rebuilt; guarantee terms; and packaging. The receipt must say the specialist’s fitting is not medical advice. Sellers must offer an in‑person fitting in Nebraska before selling to a Nebraska resident. At delivery, the specialist must confirm the device works and fits; if the sale happens away from their office and that office is not nearby, you must get a nearby affiliate address for follow‑up fittings.

Only licensees may fit hearing aids

Only people with a current hearing instrument specialist license may order or fit hearing instruments. No one may advertise these services without a valid, unsuspended license.

Pharmacy emergency refills and clinic dispensing

Public health clinics with a delegated permit can dispense listed drugs and devices without a pharmacist onsite. Prescriptions must be written by a Nebraska‑licensed practitioner at the clinic or affiliated with it, and clinics must follow labeling, formulary, and pharmacist‑availability rules. If your prescriber cannot be reached, a pharmacist may give a one‑time emergency refill of a non‑controlled maintenance medicine. It is limited to seven days or the smallest package, only once every six months. The pharmacist must tell you it was without prescriber approval, document it, and notify the prescriber within 72 hours.

Certified hearing pros may be trainers

Licensed hearing instrument specialists with NBC‑HIS certification or a board‑recognized advanced credential may work as trainers. They can provide hands‑on training in hearing instrument sciences for an employer.

New paths to hearing specialist licenses

To be licensed, you must pass the exam, be at least 21, and have a high‑school‑equivalent education. You must also meet one path: required practicum hours; a two‑year hearing‑sciences degree; a current out‑of‑state license for 12 of the last 18 months; National Board certification at exam time; or an advanced International Hearing Society credential. The department may consider foreign‑educated applicants and may waive exam parts if the board recommends it. Trainees must be supervised by a licensed specialist or an audiologist with adequate personal contact. The exam includes a competency test, a practical test, and a law test, with set retake rules; after repeated failures you must meet the board and complete a training plan before another retake.

Stronger supervision for school speech aides

School speech aides must work under the direct supervision of a licensed speech‑language pathologist. This protects students and clarifies who oversees services.

Safer earwax removal by specialists

Before removing earwax, a specialist must have two years of undisciplined licensure, finish a board‑approved course with at least six hours of hands‑on practice, and carry liability insurance. After that, they take one hour of earwax‑specific continuing education each year. They must follow infection‑control rules, including OSHA 29 C.F.R. 1910 as of January 1, 2025, and keep a case history, signed consent, and before‑and‑after video‑otoscopy pictures for seven years. Removal is limited to the outer one‑third of the ear canal and allowed for listed reasons; minors and people with listed problems (like a perforated eardrum, prior ear surgery or tubes, bleeding disorders, suspected foreign body, or when the eardrum is not visible) must be referred. If trauma, heavy bleeding, severe pain, sudden hearing loss, or sudden dizziness occurs, the specialist must get immediate medical help. Patients cannot be asked to waive liability. These protections can also limit where and when removal is offered.

Stronger hearing test and fitting rules

A licensed specialist must do a face‑to‑face hearing test, or use a signed test from the last six months, before ordering or fitting a device. The test must include air‑conduction at 250–8,000 Hz, bone‑conduction at 500–4,000 Hz, inter‑octaves when differences exceed 15 dB, masking when needed, and speech measures. Specialists must show your benefit using objective measures or validated questionnaires. Audiometers must be calibrated within the last 12 months and checked yearly; keep calibration records for ten years. If you have FDA‑listed warning signs, the specialist must advise you to see an ear doctor before dispensing. If you repurchase and already have a medical exam showing a permanent condition (ear deformity; stable one‑sided/asymmetric loss; or an air‑bone gap ≥15 dB at 500, 1000, and 2000 Hz), you do not need a new exam. These steps add checks but aim for safer, effective fittings.

Who can provide hearing services

The law defines what ordering and fitting include (case history, otoscopy, tests, ear impressions or scans, training, and aftercare) and what they do not include (medical diagnosis, tinnitus treatment, foreign‑body removal). Licensed specialists can order, fit, sell, and service devices and may order devices under 21 C.F.R. 801.109 as of January 1, 2025. Doctors and audiologists may delegate fitting or dispensing only to licensed hearing instrument specialists. Specialists generally serve people 18 or older; care for minors is limited unless federal law bars that age limit. Licensees must follow FDA hearing‑device rules in 21 C.F.R. 801.422 as of January 1, 2025, and the definition of “hearing instrument” excludes devices with implantable parts.

New assistant funeral director role

The law creates the job title “assistant funeral director.” A funeral director who employs an assistant must sign a collaborative agreement, supervise the assistant, and keep records of the agreement and the assistant’s work.

New rules for funeral assistants and apprentices

Assistant funeral directors must pass a Nebraska law exam. They must be employed by a licensed funeral director and have a signed collaborative agreement for each job. Assistants may help with funerals, burials, family meetings, and daily operations, but only under supervision. Assistants cannot embalm; doing so ends their employment and agreement right away. The department can discipline license holders who do not follow these assistant rules. Funeral apprentices must complete their first 25 assists and embalmings with the supervisor onsite.

Stores may sell hearing aids with licensees

A corporation, partnership, LLC, trust, or association may sell hearing instruments at retail without its own organization license. The business must have a regular business address, employ only properly licensed people to handle direct sales and fittings, and file a yearly list of those licensees with the department.

Immediate start and statute cleanup

The act takes effect when passed and approved because it declares an emergency. It also repeals the specific older law sections listed in the act.

Who sits on Pharmacy Board changes

The Nebraska Board of Pharmacy now has five practicing pharmacists, one pharmacy technician, and two public members. At least one pharmacist must practice in a hospital.

Sponsors & Cosponsors

Sponsor

  • Brian Hardin

    Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 266 • No: 0

legislature vote • 5/14/2025

Final Reading

Yes: 49 • No: 0

legislature vote • 4/23/2025

Vote

Yes: 37 • No: 0 • Other: 12

legislature vote • 4/2/2025

Vote

Yes: 29 • No: 0 • Other: 20

legislature vote • 4/2/2025

Vote

Yes: 28 • No: 0 • Other: 21

legislature vote • 4/2/2025

Vote

Yes: 29 • No: 0 • Other: 20

legislature vote • Unknown

Vote

Yes: 29 • No: 0 • Other: 20

legislature vote • Unknown

Vote

Yes: 28 • No: 0 • Other: 21

legislature vote • Unknown

Vote

Yes: 37 • No: 0 • Other: 12

Actions Timeline

  1. Provisions/portions of LB697 amended into LB332 by AM729

    6/6/2025legislature

  2. Provisions/portions of LB555 amended into LB332 by AM729

    6/6/2025legislature

  3. Provisions/portions of LB515 amended into LB332 by AM729

    6/6/2025legislature

  4. Provisions/portions of LB154 amended into LB332 by AM729

    6/6/2025legislature

  5. Provisions/portions of LB119 amended into LB332 by AM828

    6/6/2025legislature

  6. Approved by Governor on May 20, 2025

    5/20/2025legislature

  7. Presented to Governor on May 14, 2025

    5/14/2025legislature

  8. President/Speaker signed

    5/14/2025legislature

  9. Passed on Final Reading with Emergency Clause 49-0-0

    5/14/2025legislature

  10. Dispensing of reading at large approved

    5/14/2025legislature

  11. Enrollment and Review ST25 recorded

    4/29/2025legislature

  12. Enrollment and Review ST25 filed

    4/29/2025legislature

  13. Placed on Final Reading with ST25

    4/29/2025legislature

  14. Advanced to Enrollment and Review for Engrossment

    4/23/2025legislature

  15. Hardin AM1154 adopted

    4/23/2025legislature

  16. Hardin AM1154 filed

    4/23/2025legislature

  17. Hardin AM1117 withdrawn

    4/23/2025legislature

  18. Enrollment and Review ER42 adopted

    4/23/2025legislature

  19. Hardin AM1117 to ER42 filed

    4/22/2025legislature

  20. Enrollment and Review ER42 filed

    4/9/2025legislature

  21. Placed on Select File with ER42

    4/9/2025legislature

  22. Advanced to Enrollment and Review Initial

    4/2/2025legislature

  23. Health and Human Services AM729 adopted

    4/2/2025legislature

  24. Hardin AM828 adopted

    4/2/2025legislature

  25. Hardin AM828 to AM729 filed

    3/31/2025legislature

Bill Text

  • Introduced

    1/16/2025

    PDF

  • Enrolled / Slip Law

    PDF

  • Final / Enacted

    PDF

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