™Your Policy Risk Impact Agent
2,111 sections in this chapter.
Neb. Rev. Stat. § 44-7109 Health carrier violation; notice; hearing.
0.4K chars
If the director finds that any health carrier doing business in this state is engaging in any violation of the Managed Care Network Adequacy Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a…
Neb. Rev. Stat. § 44-711 Sickness and accident insurance; hearing on policy form; disapproval; appeal.
0.7K chars
After the expiration of such thirty days from the filing of any such form, as provided in section 44-710, or at any time after having given written approval thereof, the director may, after a hearing of which at least ten days' written notice has been given to the insurer issuing…
Neb. Rev. Stat. § 44-7110 Violation; penalty.
1.0K chars
If, after the hearing, the director finds a health carrier has violated the Managed Care Network Adequacy Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings…
Neb. Rev. Stat. § 44-7111 Violation of cease and desist order; penalty.
0.4K chars
Any health carrier who violates a cease and desist order of the director under section 44-7110 may after notice and hearing and upon order of the director be subject to: (1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate…
Neb. Rev. Stat. § 44-7112 Rules and regulations.
0.1K chars
The director may adopt and promulgate rules and regulations to carry out the Managed Care Plan Network Adequacy Act.
Neb. Rev. Stat. § 44-712 Sickness and accident insurance; good faith estimate; requirements; effect.
1.8K chars
(1) Any individual or group sickness and accident insurance policy or subscriber contract, any hospital, medical, or surgical expense-incurred policy, and any prepaid dental service plan that is issued for delivery, delivered, or renewed in this state, except policies that provid…
Neb. Rev. Stat. § 44-713 Insured in temporary custody; health insurance policy; insurer; duties; powers; incarceration; notice; refusal to credential health care provider; notice; applicability of section.
4.9K chars
(1) For purposes of this section: (a) Notwithstanding section 44-3,131, health insurance policy means (i) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or s…
Neb. Rev. Stat. § 44-714 Health benefit plan; plan sponsor; electronic delivery of communications; consent on behalf of covered person; conditions.
1.8K chars
(1) For purposes of this section: (a) Health benefit plan means a policy, a contract, a certificate, or an agreement entered into, offered by, or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a vis…
Neb. Rev. Stat. § 44-7201 Act, how cited.
0.1K chars
Sections 44-7201 to 44-7215 shall be known and may be cited as the Quality Assessment and Improvement Act.
Neb. Rev. Stat. § 44-7202 Purpose and intent.
0.4K chars
The Quality Assessment and Improvement Act establishes criteria for the quality assessment activities of all health carriers that offer managed care plans and for the quality improvement activities of health carriers issuing closed plans or combination plans having a closed compo…
Neb. Rev. Stat. § 44-7203 Terms, defined.
3.8K chars
For purposes of the Quality Assessment and Improvement Act: (1) Closed plan means a managed care plan that requires a covered person to use participating providers under the terms of the managed care plan; (2) Consumer means someone in the general public who may or may not be a c…
Neb. Rev. Stat. § 44-7204 Applicability of act.
0.3K chars
The Quality Assessment and Improvement Act applies to all health carriers that offer closed plans or combination plans having a closed component on and after July 15, 1998. The act, except sections 44-7207 to 44-7209, applies to all health carriers that offer open plans on and af…
Neb. Rev. Stat. § 44-7205 Use of nationally recognized private accrediting entities; authorized.
0.6K chars
The director may recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Quality Assessment and Improvement Act. A recognized accrediting en…
Neb. Rev. Stat. § 44-7206 Quality assessment; infrastructure and disclosure systems.
1.6K chars
A health carrier that provides managed care plans shall develop and maintain the infrastructure and disclosure systems necessary to measure the quality of health care services provided to covered persons on a regular basis and appropriate to the types of managed care plans offere…
Neb. Rev. Stat. § 44-7207 Quality improvement; internal structures and activities.
5.1K chars
A health carrier that issues a closed plan or a combination plan having a closed component shall, in addition to complying with the requirements of section 44-7206, develop and maintain the internal structures and activities necessary to improve quality as required by this sectio…
Neb. Rev. Stat. § 44-7208 Quality assessment and quality improvement activities; oversight.
1.0K chars
The chief medical officer or clinical director of the health carrier shall have primary responsibility for the quality assessment and quality improvement activities carried out by, or on behalf of, the health carrier and for ensuring that all requirements of the Quality Assessmen…
Neb. Rev. Stat. § 44-7209 Reporting and disclosure requirements.
1.3K chars
(1) A health carrier shall document and communicate information, as provided in this section, about its quality assessment program and its quality improvement program, if it has one, and shall include a description of its quality assessment and quality improvement programs and a …
Neb. Rev. Stat. § 44-7210 Confidentiality; immunity.
3.6K chars
(1) Data or information pertaining to the diagnosis, treatment, or health of a covered person obtained from the person or from a provider by a health carrier is confidential and shall not be disclosed to any person except to the extent that it may be necessary to carry out the pu…
Neb. Rev. Stat. § 44-7211 Contracts; duties.
0.4K chars
Whenever a health carrier contracts to have another entity perform the quality assessment or quality improvement functions required by the Quality Assessment and Improvement Act or applicable rules and regulations, the director shall hold the health carrier responsible for monito…
Neb. Rev. Stat. § 44-7212 Health carrier violation; notice; hearing.
0.4K chars
If the director finds that any health carrier doing business in this state is engaging in any violation of the Quality Assessment and Improvement Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carr…
Neb. Rev. Stat. § 44-7213 Violation; penalty.
1.1K chars
If, after the hearing, the director finds a health carrier has violated the Quality Assessment and Improvement Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the fin…
Neb. Rev. Stat. § 44-7214 Violation of cease and desist order; penalty.
0.4K chars
Any health carrier who violates a cease and desist order of the director under section 44-7213 may after notice and hearing and upon order of the director be subject to: (1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate…
Neb. Rev. Stat. § 44-7215 Rules and regulations.
0.1K chars
The director may adopt and promulgate rules and regulations to carry out the Quality Assessment and Improvement Act.
Neb. Rev. Stat. § 44-7301 Act, how cited.
0.1K chars
Sections 44-7301 to 44-7315 shall be known and may be cited as the Health Carrier Grievance Procedure Act.
Neb. Rev. Stat. § 44-7302 Purpose of act.
0.3K chars
The purpose of the Health Carrier Grievance Procedure Act is to provide standards for the establishment and maintenance of procedures by health carriers to assure that covered persons have the opportunity for the appropriate resolution of their grievances as defined in the act.
Neb. Rev. Stat. § 44-7303 Terms, defined.
8.8K chars
For purposes of the Health Carrier Grievance Procedure Act: (1) Adverse determination means a determination by a health carrier or its designee utilization review agent that an admission, availability of care, continued stay, or other health care service has been reviewed and, ba…
Neb. Rev. Stat. § 44-7304 Applicability of act.
0.1K chars
Except as otherwise specified, the Health Carrier Grievance Procedure Act applies to all health carriers that offer managed care plans.
Neb. Rev. Stat. § 44-7305 Use of nationally recognized private accrediting entities; authorized.
0.6K chars
The director may recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Health Carrier Grievance Procedure Act. A recognized accrediting en…
Neb. Rev. Stat. § 44-7306 Grievance register.
1.3K chars
(1) A health carrier shall maintain in a grievance register written records to document all grievances received during a calendar year. A request for a review of an adverse determination shall be processed in compliance with section 44-7308 but not considered a grievance for purp…
Neb. Rev. Stat. § 44-7307 Grievance procedures.
1.0K chars
(1) Except as specified in section 44-7311, a health carrier shall use written procedures for receiving and resolving grievances from covered persons. (2)(a) A copy of the grievance procedures, including all forms used to process a grievance, shall be made available to the direct…
Neb. Rev. Stat. § 44-7308 Grievance review.
4.1K chars
(1) If a covered person makes a request to a health carrier for a health care service and the request is denied, the health carrier shall provide the covered person with an explanation of the reasons for the denial, a written notice of how to submit a grievance, and the telephone…
Neb. Rev. Stat. § 44-7310 Standard review of adverse determinations.
1.4K chars
(1) A health carrier shall establish written procedures for a standard review of an adverse determination. Review procedures shall be available to a covered person and to the provider acting on behalf of a covered person. For purposes of this section, covered person includes the …
Neb. Rev. Stat. § 44-7311 Expedited reviews.
3.7K chars
(1) A health carrier shall establish written procedures for the expedited review of a grievance involving a situation in which the timeframe of the standard grievance procedures set forth in sections 44-7308 to 44-7310 would seriously jeopardize the life or health of a covered pe…
Neb. Rev. Stat. § 44-7312 Health carrier violations; notice; hearing.
0.4K chars
If the director finds that any health carrier doing business in this state is engaging in any violation of the Health Carrier Grievance Procedure Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carr…
Neb. Rev. Stat. § 44-7313 Violation; penalty.
1.1K chars
If, after the hearing, the director finds a health carrier has violated the Health Carrier Grievance Procedure Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the fin…
Neb. Rev. Stat. § 44-7314 Violation of cease and desist order; penalty.
0.4K chars
Any health carrier who violates a cease and desist order of the director under section 44-7313 may after notice and hearing and upon order of the director be subject to: (1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate…
Neb. Rev. Stat. § 44-7315 Rules and regulations.
0.1K chars
The director may adopt and promulgate rules and regulations to carry out the Health Carrier Grievance Procedure Act.
Neb. Rev. Stat. § 44-736 Sickness and accident insurance; extended disability benefit; how construed.
0.2K chars
Any policy of sickness and accident insurance may contain a provision for paying an extended disability benefit upon the insured's death from any cause, which benefit shall not be construed as life insurance.
Neb. Rev. Stat. § 44-7401 Act, how cited.
0.1K chars
Sections 44-7401 to 44-7410 shall be known and may be cited as the Unfair Discrimination Against Subjects of Abuse in Insurance Act.
Neb. Rev. Stat. § 44-7402 Terms, defined.
4.3K chars
For purposes of the Unfair Discrimination Against Subjects of Abuse in Insurance Act: (1) Abuse means the occurrence of one or more of the following acts by a current or former family member or household member: (a)(i) Attempting to cause or intentionally or knowingly causing ano…
Neb. Rev. Stat. § 44-7403 Purpose of act.
0.2K chars
The purpose of the Unfair Discrimination Against Subjects of Abuse in Insurance Act is to prohibit unfair discrimination by insurers on the basis of abuse.
Neb. Rev. Stat. § 44-7404 Applicability of act.
0.2K chars
The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all insurers issuing, providing, delivering, arranging for, or renewing in this state any policy of insurance.
Neb. Rev. Stat. § 44-7405 Subject of abuse; prohibited acts.
0.1K chars
An insurer shall not engage in an unfairly discriminatory act or practice against a subject of abuse.
Neb. Rev. Stat. § 44-7406 Prohibited acts and practices; enumerated; immunity.
8.9K chars
(1) The following acts or practices by an insurer are prohibited as unfairly discriminatory: (a) Denying, refusing to issue, renew, or reissue, canceling, or otherwise terminating, restricting, or excluding coverage on or adding a premium differential to any policy on the basis o…
Neb. Rev. Stat. § 44-7407 Adverse effect on subject of abuse; explanation required.
1.0K chars
An insurer that takes an action that adversely affects a subject of abuse on the basis of a medical condition or on the basis of claims history or other underwriting information that the insurer knows or has reason to know is abuse-related shall explain the reason for its action …
Neb. Rev. Stat. § 44-7408 Violation of act; unfair trade practice.
0.3K chars
In addition to any other remedies available under the laws of this state, each violation of the Unfair Discrimination Against Subjects of Abuse in Insurance Act and any rules and regulations adopted and promulgated thereunder shall be an unfair trade practice in the business of i…
Neb. Rev. Stat. § 44-7409 Rules and regulations.
0.1K chars
The director may adopt and promulgate rules and regulations to carry out the Unfair Discrimination Against Subjects of Abuse in Insurance Act.
Neb. Rev. Stat. § 44-7410 Applicability to actions on or after July 15, 1998.
0.4K chars
The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all actions taken on or after July 15, 1998, except as otherwise explicitly stated. Nothing in the act shall require an insurer to conduct a comprehensive search of its contract files existing on July…
Neb. Rev. Stat. § 44-749 Sickness and accident insurance; discrimination prohibited; differences permitted.
0.6K chars
No sickness and accident insurer shall make or permit any unfair discrimination between individuals of substantially the same hazard in the amount of premium rates charged for any policy or contract of such insurance or in the benefits payable thereunder. This section shall not p…
Neb. Rev. Stat. § 44-7501 Act, how cited.
0.1K chars
Sections 44-7501 to 44-7535 shall be known and may be cited as the Property and Casualty Insurance Rate and Form Act.