All Roll Calls
Yes: 86 • No: 2
NebraskaLB380A109th Legislature 1st and 2nd SessionslegislatureWALLET
Appropriation Bill
Sponsored By: John Fredrickson
Signed by Governor
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 4 benefits, 0 costs, 3 mixed.
Caps on Medicaid plan overhead and profit
Managed care plans must spend at least 85% of revenue on medical care. Admin costs are capped at 12% and must be tracked and reported each quarter. Profit is capped at 3% a year, and extra incentives are capped at 2%. If a plan misses the 85% rule or goes over limits, it must return the money to the state’s Excess Profit Fund.
Higher Medicaid plan payments from 2026
Beginning January 1, 2026, the state can start higher capitation payments to Medicaid plans once federal approval is obtained. This directs more money into managed care rates for services on or after that date.
Stronger mental health coverage in Medicaid
The law enforces mental health and addiction care at the same level as other medical care. Plans must keep enough behavioral health providers and cannot cancel an approval after care is given, except for fraud or a contract breach. The Medicaid Division enforces children’s EPSDT rules and access parity with medical and surgical care. Plans must use accepted care standards and share their review rules. The state defines what counts as an adequate network and posts each plan’s status every year.
Excess profits fund boosts health services
The state created a Medicaid Managed Care Excess Profit Fund. Returned plan money first covers losses, then pays only for listed health needs. Uses include early home visiting, medical respite, translation, continuous glucose monitors, keeping access to care, the Prenatal Plus Program, and certain grants. Starting October 1, 2024, investment earnings from the fund go to the state’s General Fund, not back into this fund.
Ambulance transport add-on tied to cost
Eligible ground ambulance providers can get a supplemental Medicaid payment per transport based on actual, allowable costs. Total Medicaid payments cannot exceed 100% of actual costs and depend on available federal match. Government entities that claim these funds must certify under 42 C.F.R. 433.51 (as of January 1, 2025), keep retrievable records, and submit required data. The state must apply to CMS by January 1, 2026 to add this to the Medicaid plan. The program runs only with federal approval and available match; the CEO may refuse or adjust transfers to meet federal rules, and payments stop if a court or CMS requires it. The state only claims federal match for allowable costs and gives annual assurances.
Fairer Medicaid audits for providers
Auditors must give a written reason to start an audit. Record requests must be specific, relevant, and proportional. After you submit all records, the auditor must issue a final decision within 180 days. Audits can still look back at past payments within a set multi‑year window, so some past claims can be recouped.
More transparency and oversight of Medicaid plans
The state posts plan surveys, financial checks, audits, and parity reports for the public. Providers get monthly electronic notices about contract changes. At‑risk managed care contracts must be competitively bid under Nebraska rules. Older statute sections are repealed to update the law.
Sponsors & Cosponsors
Sponsor
John Fredrickson
legislature
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
legislature vote • 5/28/2025
Final Reading
Yes: 47 • No: 2
legislature vote • 5/1/2025
Vote
Yes: 39 • No: 0 • Other: 10
Actions Timeline
Approved by Governor on May 30, 2025
6/2/2025legislaturePassed on Final Reading 47-2*-0
5/28/2025legislaturePresident/Speaker signed
5/28/2025legislaturePresented to Governor on May 28, 2025
5/28/2025legislaturePlaced on Final Reading
5/19/2025legislatureAdvanced to Enrollment and Review for Engrossment
5/14/2025legislaturePlaced on Select File
5/6/2025legislatureAdvanced to Enrollment and Review Initial
5/1/2025legislatureDate of introduction
4/15/2025legislaturePlaced on General File
4/15/2025legislature
Bill Text
Introduced
6/2/2025
Enrolled / Slip Law
Final / Enacted