Chapter 68 — PUBLIC ASSISTANCE
697 sections in this chapter.
Neb. Rev. Stat. § 68-905 Program of medical assistance; statement of public policy.
1.2K chars
It is the public policy of the State of Nebraska to provide a program of medical assistance on behalf of eligible low-income Nebraska residents that (1) assists eligible recipients to access necessary and appropriate health care and related services, (2) emphasizes prevention, ea…
Neb. Rev. Stat. § 68-906 Medical assistance; state accepts federal provisions.
0.4K chars
For purposes of paying medical assistance under the Medical Assistance Act and sections 68-1002 and 68-1006, the State of Nebraska accepts and assents to all applicable provisions of Title XIX and Title XXI of the federal Social Security Act. Any reference in the Medical Assistan…
Neb. Rev. Stat. § 68-907 Terms, defined.
3.0K chars
For purposes of the Medical Assistance Act: (1) Committee means the Health and Human Services Committee of the Legislature; (2) Department means the Department of Health and Human Services; (3) Medicaid Reform Plan means the Medicaid Reform Plan submitted on December 1, 2005, pur…
Neb. Rev. Stat. § 68-908 Department; powers and duties.
6.5K chars
(1) The department shall administer the medical assistance program. (2) The department may (a) enter into contracts and interagency agreements, (b) adopt and promulgate rules and regulations, (c) adopt fee schedules, (d) apply for and implement waivers and managed care plans for …
Neb. Rev. Stat. § 68-908.01 Dental services; reimbursement rates.
0.2K chars
It is the intent of the Legislature to increase reimbursement rates by twelve and one-half percent for fiscal year 2024-25 for dental services provided under the Medical Assistance Act.
Neb. Rev. Stat. § 68-909 Existing contracts, agreements, rules, regulations, plan, and waivers; how treated; department; powers and duties.
0.7K chars
(1) All contracts, agreements, rules, and regulations relating to the medical assistance program as entered into or adopted and promulgated by the department prior to July 1, 2006, and all provisions of the medicaid state plan and waivers adopted by the department prior to July 1…
Neb. Rev. Stat. § 68-910 Medical assistance payments; source of funds.
1.0K chars
(1) Medical assistance shall be paid from General Funds, cash funds, federal funds, and such other funds as may qualify for federal matching funds under federal law. General Fund appropriations for the program shall be based on an assessment by the Legislature of General Fund rev…
Neb. Rev. Stat. § 68-911 Medical assistance; mandated and optional coverage; department; submit state plan amendment or waiver; specified coverage requirements.
9.6K chars
(1) Medical assistance shall include coverage for health care and related services as required under Title XIX of the federal Social Security Act, including, but not limited to: (a) Inpatient and outpatient hospital services; (b) Laboratory and X-ray services; (c) Nursing facilit…
Neb. Rev. Stat. § 68-912 Limits on goods and services; considerations; procedure.
2.8K chars
(1) The department may establish (a) premiums, copayments, and deductibles for goods and services provided under the medical assistance program, (b) limits on the amount, duration, and scope of goods and services that recipients may receive under the medical assistance program su…
Neb. Rev. Stat. § 68-913 Medical assistance program; public awareness; public school district; hospital; duties.
0.8K chars
(1) Each public school district shall annually, at the beginning of the school year, provide written information supplied by the department to every student describing the availability of children's health services provided under the medical assistance program. (2) Each hospital …
Neb. Rev. Stat. § 68-914 Application for medical assistance; form; department; decision; notice; requirements; appeal.
1.8K chars
(1) An applicant for medical assistance shall file an application with the department in a manner and form prescribed by the department. The department shall process each application to determine whether the applicant is eligible for medical assistance. The department shall provi…
Neb. Rev. Stat. § 68-915 Eligibility.
4.5K chars
The following persons shall be eligible for medical assistance: (1) Dependent children as defined in section 43-504; (2) Aged, blind, and disabled persons as defined in sections 68-1002 to 68-1005; (3) Children under nineteen years of age who are eligible under section 1905(a)(i)…
Neb. Rev. Stat. § 68-916 Medical assistance; application; assignment of rights; exception.
1.4K chars
The application for medical assistance shall constitute an automatic assignment of the rights specified in this section to the department or its assigns effective from the date of eligibility for such assistance. The assignment shall include the rights of the applicant or recipie…
Neb. Rev. Stat. § 68-917 Applicant or recipient; failure to cooperate; effect.
0.9K chars
Refusal by the applicant or recipient specified in section 68-916 to cooperate in obtaining reimbursement for medical care or services provided to himself or herself or any other member of the assistance group renders the applicant or recipient ineligible for assistance. Ineligib…
Neb. Rev. Stat. § 68-918 Restoration of rights; when.
0.2K chars
If the applicant or recipient or any member of the assistance group becomes ineligible for medical assistance, the department shall restore to him or her the rights assigned under section 68-916.
Neb. Rev. Stat. § 68-919 Medical assistance recipient; liability; when; claim; procedure; department; powers; recovery of medical assistance reimbursement; procedure.
11.3K chars
(1) The recipient of medical assistance under the medical assistance program shall be indebted to the department for the total amount paid for medical assistance on behalf of the recipient if: (a) The recipient was fifty-five years of age or older at the time the medical assistan…
Neb. Rev. Stat. § 68-920 Department; garnish employment income; when; limitation.
0.8K chars
The department may garnish the wages, salary, or other employment income of a person for the costs of health services provided to a child who is eligible for medical assistance pursuant to the medical assistance program if: (1) The person is required by court or administrative or…
Neb. Rev. Stat. § 68-921 Entitlement of spouse; terms, defined.
2.1K chars
For purposes of sections 68-921 to 68-925: (1) Assets means property which is not exempt from consideration in determining eligibility for medical assistance under rules and regulations adopted and promulgated under section 68-922; (2) Community spouse monthly income allowance me…
Neb. Rev. Stat. § 68-922 Amount of entitlement; department; rules and regulations.
0.6K chars
For purposes of determining medical assistance eligibility and the right to and obligation of medical support pursuant to sections 68-716, 68-915, and 68-916, a spouse may retain (1) assets equivalent to the community spouse resource allowance and (2) an amount of income equivale…
Neb. Rev. Stat. § 68-923 Assets; eligibility for assistance; future medical support; considerations; subrogation.
1.1K chars
If a portion of the aggregate assets is designated in accordance with section 68-924: (1) Only the assets not designated for the spouse shall be considered in determining the eligibility of an applicant for medical assistance; (2) In determining the eligibility of an applicant, t…
Neb. Rev. Stat. § 68-924 Designation of assets; procedure.
0.7K chars
A designation of assets pursuant to section 68-922 shall be evidenced by a written statement listing such assets and signed by the spouse. A copy of such statement shall be provided to the department at the time of application and shall designate assets owned as of the date of ap…
Neb. Rev. Stat. § 68-925 Department; furnish statement.
0.2K chars
The department shall furnish to each qualified applicant for and each qualified recipient of medical assistance a clear and simple written statement explaining the provisions of section 68-922.
Neb. Rev. Stat. § 68-926 Legislative findings.
0.8K chars
The Legislature finds that (1) the department relies on health insurance and claims information from private insurers to ensure accuracy in processing state benefit program payments to providers and in verifying individual recipients' eligibility, (2) delay or refusal to provide …
Neb. Rev. Stat. § 68-927 Terms, defined.
1.7K chars
For purposes of sections 68-926 to 68-933: (1) Coordinate benefits means: (a) Provide to the department information regarding the licensed insurer's or self-funded insurer's existing coverage for an individual who is eligible for a state benefit program; and (b) Meet payment obli…
Neb. Rev. Stat. § 68-928 Licensed insurer or self-funded insurer; provide coverage information; health plan; requirements regarding claims.
2.4K chars
(1) Except as provided in subsection (2) of this section, at the request of the department, a licensed insurer or a self-funded insurer shall provide coverage information to the department without an individual's authorization for purposes of: (a) Determining an individual's elig…
Neb. Rev. Stat. § 68-929 Licensed insurer; violation.
0.1K chars
Any violation of section 68-928 by a licensed insurer shall be subject to the Unfair Insurance Claims Settlement Practices Act.
Neb. Rev. Stat. § 68-930 Self-funded insurer; violation; civil penalty.
0.8K chars
The department may impose and collect a civil penalty on a self-funded insurer who violates the requirements of section 68-928 if the department finds that the self-funded insurer: (1) Committed the violation flagrantly and in conscious disregard of the requirements; or (2) Has c…
Neb. Rev. Stat. § 68-931 Recovery; authorized.
0.2K chars
The department is authorized to recover all amounts paid or to be paid to state benefit programs as a result of failure to coordinate benefits by a licensed insurer or a self-funded insurer.
Neb. Rev. Stat. § 68-932 Process for resolving violations; appeal.
0.3K chars
The department shall establish a process by rule and regulation for resolving any violation by a self-funded insurer of section 68-928 and for assessing the financial penalties contained in section 68-930. Any appeal of an action by the department under such policies shall be in …
Neb. Rev. Stat. § 68-933 Civil penalties; disposition.
0.2K chars
All money collected as a civil penalty under section 68-929 or 68-930 shall be remitted to the State Treasurer for distribution in accordance with Article VII, section 5, of the Constitution of Nebraska.
Neb. Rev. Stat. § 68-934 False Medicaid Claims Act; act, how cited.
0.1K chars
Sections 68-934 to 68-947 shall be known and may be cited as the False Medicaid Claims Act.
Neb. Rev. Stat. § 68-935 Terms, defined.
2.3K chars
For purposes of the False Medicaid Claims Act: (1) Attorney General means the Attorney General, the office of the Attorney General, or a designee of the Attorney General; (2) Claim means any request or demand, whether under a contract or otherwise, for money or property, and whet…
Neb. Rev. Stat. § 68-936 Presentation of false medicaid claim; civil liability; violation of act; civil penalty; damages; costs and attorney's fees.
2.0K chars
(1) A person presents a false medicaid claim and is subject to civil liability if such person: (a) Knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval; (b) Knowingly makes, uses, or causes to be made or used, a false record or statem…
Neb. Rev. Stat. § 68-937 Failure to report.
0.5K chars
A person violates the False Medicaid Claims Act, and is subject to civil liability as provided in section 68-936, if such person is a beneficiary of an inadvertent submission of a false medicaid claim to the state, and subsequently discovers and, knowing the claim is false, fails…
Neb. Rev. Stat. § 68-938 Charge, solicitation, acceptance, or receipt; unlawful; when.
0.6K chars
A person violates the False Medicaid Claims Act, and a claim submitted with regard to a good or service is deemed to be false and subjects such person to civil liability as provided in section 68-936, if he or she, acting on behalf of a provider providing such good or service to …
Neb. Rev. Stat. § 68-939 Records; duties; acts prohibited; liability; costs and attorney's fees.
1.3K chars
(1) A person violates the False Medicaid Claims Act and is subject to civil liability as provided in section 68-936 and damages as provided in subsection (2) of this section if he or she: (a) Having submitted a claim or received payment for a good or service under the medical ass…
Neb. Rev. Stat. § 68-940 Penalties or damages; considerations; liability; costs and attorney's fees.
2.3K chars
(1) In determining the amount of any penalties or damages awarded under the False Medicaid Claims Act, the following shall be taken into account: (a) The nature of claims and the circumstances under which they were presented; (b) The degree of culpability and history of prior off…
Neb. Rev. Stat. § 68-940.01 State Medicaid Fraud Control Unit Cash Fund; created; use; investment.
1.2K chars
The State Medicaid Fraud Control Unit Cash Fund is created. The fund shall be maintained by the Department of Justice and administered by the Attorney General. The fund shall consist of any recovery for the state's costs and attorney's fees received pursuant to subdivision (2)(b)…
Neb. Rev. Stat. § 68-941 Limitation of actions; burden of proof.
0.5K chars
(1) A civil action under the False Medicaid Claims Act shall be brought within six years after the date the claim is discovered or should have been discovered by exercise of reasonable diligence and, in any event, no more than ten years after the date on which the violation of th…
Neb. Rev. Stat. § 68-942 Investigation and prosecution.
0.5K chars
(1) In any case involving allegations of civil violations or criminal offenses under the False Medicaid Claims Act, the Attorney General may take full charge of any investigation or advancement or prosecution of the case. (2) The department shall cooperate with the state medicaid…
Neb. Rev. Stat. § 68-943 State medicaid fraud control unit; certification.
0.3K chars
The Attorney General shall: (1) Establish a state medicaid fraud control unit that meets the standards prescribed by 42 U.S.C. 1396b(q); and (2) Apply to the Secretary of Health and Human Services for certification of the unit under 42 U.S.C. 1396b(q).
Neb. Rev. Stat. § 68-944 State medicaid fraud control unit; powers and duties.
1.0K chars
The state medicaid fraud control unit shall employ such attorneys, auditors, investigators, and other personnel as authorized by law to carry out the duties of the unit in an effective and efficient manner. The purpose of the state medicaid fraud control unit is to conduct a stat…
Neb. Rev. Stat. § 68-945 Attorney General; powers and duties.
1.1K chars
In carrying out the duties and responsibilities under the False Medicaid Claims Act, the Attorney General may: (1) Enter upon the premises of any provider participating in the medical assistance program (a) to examine all accounts and records that are relevant in determining the …
Neb. Rev. Stat. § 68-946 Attorney General; access to records.
1.2K chars
(1) Notwithstanding any other provision of law, the Attorney General, upon reasonable request, shall have full access to all records held by a provider, or by any other person on the provider's behalf, that are relevant to the determination of (a) the existence of civil violation…
Neb. Rev. Stat. § 68-947 Contempt of court.
0.6K chars
Any person who, after being ordered by a court to comply with a subpoena issued under the False Medicaid Claims Act, fails in whole or in part to testify or to produce evidence, documentary or otherwise, shall be in contempt of court as if the failure was committed in the presenc…
Repealed. Laws 2017, LB644, § 21.
0.0K chars
[Repealed or reserved.]
Neb. Rev. Stat. § 68-949 Medical assistance program; legislative intent; department; duties; medicaid nursing facility rates; appropriations; reports; money follows the person program.
4.3K chars
(1) It is the intent of the Legislature that the department implement reforms to the medical assistance program such as those contained in the Medicaid Reform Plan, including (a) an incremental expansion of home and community-based services for aged persons and persons with disab…
Neb. Rev. Stat. § 68-950 Medicaid Prescription Drug Act, how cited.
0.1K chars
Sections 68-950 to 68-956 shall be known and may be cited as the Medicaid Prescription Drug Act.
Neb. Rev. Stat. § 68-951 Purpose of act.
0.4K chars
The purpose of the Medicaid Prescription Drug Act is to provide appropriate pharmaceutical care to medicaid recipients in a cost-effective manner by requiring the establishment of a preferred drug list and other activities as prescribed. The preferred drug list and other activiti…
Neb. Rev. Stat. § 68-952 Terms, defined.
1.0K chars
For purposes of the Medicaid Prescription Drug Act: (1) Labeler means a person or entity that repackages prescription drugs for retail sale and has a labeler code from the federal Food and Drug Administration under 21 C.F.R. 207.20, as such regulation existed on January 1, 2008; …