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NebraskaLB380109th Legislature 1st and 2nd Sessionslegislature

Change provisions regarding program integrity, ground emergency medical transport, and mental health and substance use disorder services under the Medical Assistance Act and provide duties for the Division of Medicaid and Long-Term Care

Sponsored By: John Fredrickson

Signed by Governor

Health and Human Services Committee

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

Stronger mental health care in Medicaid

The law strengthens mental health and substance use care in Medicaid. Plans cannot put stricter limits or higher costs on these services than on medical care. Plans must keep enough providers and use review rules that match accepted standards. They must post their review policies and usually cannot cancel an approval after care is given, except for fraud or a contract violation. The Division of Medicaid and Long-Term Care enforces these rules, checks networks and payments, publishes audits and parity reports, and posts each plan’s compliance each year. The Division also sends monthly updates to providers about managed care contract changes.

Tighter profit caps for Medicaid plans

The law caps Medicaid plan overhead and profit to push more dollars to care. Administrative spending is capped at 12%, profit at 3% a year, and the medical loss ratio must be at least 85%. Plan incentives are limited to 2%, and excess or unearned funds must go to the Medicaid Managed Care Excess Profit Fund. Money in that fund first covers certain losses, then pays for Medicaid services like filling care gaps, home visiting, medical respite, translation, continuous glucose monitors, Prenatal Plus, and related grants. Investment earnings from October 1, 2024 go to the General Fund.

New rules for ambulance Medicaid payments

The law sets new rules for Medicaid payments to ground ambulance providers. Total Medicaid payments cannot be more than 100% of actual allowable costs, and supplemental payments cannot exceed the federal share. Government ambulance sponsors must certify under 42 C.F.R. 433.51 (as of January 1, 2025), submit data, and keep records. The department may limit costs to those allowed under Title XIX, may refuse noncompliant transfers, and may choose whether to claim federal matching funds. The department can seek federal approvals by January 1, 2026, and higher capitation tied to this program can start only for services on or after January 1, 2026 if approved. Payments may be per transport or another federally allowed method tied to actual costs.

Sponsors & Cosponsors

Sponsor

  • John Fredrickson

    Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 182 • No: 1

legislature vote • 5/28/2025

Final Reading

Yes: 48 • No: 1

legislature vote • 4/2/2025

Vote

Yes: 26 • No: 0 • Other: 23

legislature vote • 4/2/2025

Vote

Yes: 32 • No: 0 • Other: 17

legislature vote • 4/2/2025

Vote

Yes: 25 • No: 0 • Other: 24

legislature vote • Unknown

Vote

Yes: 25 • No: 0 • Other: 24

legislature vote • Unknown

Vote

Yes: 26 • No: 0 • Other: 23

Actions Timeline

  1. Provisions/portions of LB610 amended into LB380 by AM814

    6/6/2025legislature

  2. Provisions/portions of LB381 amended into LB380 by AM728

    6/6/2025legislature

  3. Approved by Governor on May 30, 2025

    5/30/2025legislature

  4. Presented to Governor on May 28, 2025

    5/28/2025legislature

  5. President/Speaker signed

    5/28/2025legislature

  6. Passed on Final Reading 48-1*-0

    5/28/2025legislature

  7. Dispensing of reading at large approved

    5/28/2025legislature

  8. Placed on Final Reading

    5/6/2025legislature

  9. Advanced to Enrollment and Review for Engrossment

    4/30/2025legislature

  10. Fredrickson AM1034 withdrawn

    4/30/2025legislature

  11. Enrollment and Review ER39 adopted

    4/30/2025legislature

  12. Fredrickson AM1034 filed

    4/14/2025legislature

  13. Enrollment and Review ER39 filed

    4/8/2025legislature

  14. Placed on Select File with ER39

    4/8/2025legislature

  15. Advanced to Enrollment and Review Initial

    4/2/2025legislature

  16. Fredrickson FA79 withdrawn

    4/2/2025legislature

  17. Fredrickson FA79 filed

    4/2/2025legislature

  18. Health and Human Services AM728 adopted

    4/2/2025legislature

  19. Bostar AM814 adopted

    4/2/2025legislature

  20. Bostar AM814 to AM728 filed

    3/28/2025legislature

  21. Health and Human Services AM728 filed

    3/26/2025legislature

  22. Placed on General File with AM728

    3/26/2025legislature

  23. Fredrickson priority bill

    3/14/2025legislature

  24. Notice of hearing for February 26, 2025

    2/7/2025legislature

  25. Referred to Health and Human Services Committee

    1/21/2025legislature

Bill Text

  • Introduced

    1/16/2025

    PDF

  • Enrolled / Slip Law

    PDF

  • Final / Enacted

    PDF

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