Chapter 68 — PUBLIC ASSISTANCE
697 sections in this chapter.
Neb. Rev. Stat. § 68-953 Preferred drug list; department; establish and maintain; pharmaceutical and therapeutics committee; members; expenses.
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(1) No later than July 1, 2010, the department shall establish and maintain a preferred drug list for the medical assistance program. The department shall establish a pharmaceutical and therapeutics committee to advise the department on all matters relating to the establishment a…
Neb. Rev. Stat. § 68-954 Preferred drug list; considerations; availability of list.
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(1) The department and the pharmaceutical and therapeutics committee shall consider all therapeutic classes of prescription drugs for inclusion on the preferred drug list, except that antidepressant, antipsychotic, and anticonvulsant prescription drugs shall not be subject to con…
Neb. Rev. Stat. § 68-955 Prescription of drug not on preferred drug list; conditions; antidepressant, antipsychotic, or anticonvulsant prescription drug; prior authorization; not required, when.
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(1) Except as otherwise provided in subsection (3) of this section, a health care provider may prescribe a prescription drug not on the preferred drug list to a medicaid recipient if (a) the prescription drug is medically necessary, (b)(i) the provider certifies that the preferre…
Neb. Rev. Stat. § 68-956 Department; duties; contract; pharmacy benefit manager; comply with Pharmacy Benefit Manager Licensure and Regulation Act.
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(1) The department shall (a) enter into a multistate purchasing pool, (b) negotiate directly with manufacturers or labelers, or (c) contract with a pharmacy benefit manager for negotiated discounts or rebates for all prescription drugs under the medical assistance program in orde…
Repealed. Laws 2017, LB4, § 1.
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[Repealed or reserved.]
Repealed. Laws 2017, LB4, § 1.
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[Repealed or reserved.]
Repealed. Laws 2017, LB4, § 1.
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[Repealed or reserved.]
Repealed. Laws 2017, LB4, § 1.
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[Repealed or reserved.]
Repealed. Laws 2017, LB4, § 1.
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[Repealed or reserved.]
Neb. Rev. Stat. § 68-962 Autism Treatment Program Act; act, how cited.
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Sections 68-962 to 68-966 shall be known and may be cited as the Autism Treatment Program Act.
Neb. Rev. Stat. § 68-963 Purpose of Autism Treatment Program Act.
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The purpose of the Autism Treatment Program Act is to provide for the development and administration of a waiver or an amendment to an existing waiver under the medical assistance program established in section 68-903.
Neb. Rev. Stat. § 68-964 Autism Treatment Program; created; administration; funding.
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The Autism Treatment Program is created. The program shall be administered by the department.
Neb. Rev. Stat. § 68-965 Autism Treatment Program Cash Fund; created; use; investment.
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(1) The Autism Treatment Program Cash Fund is created. The fund shall include revenue received from gifts, grants, bequests, donations, other similar donation arrangements, or other contributions from public or private sources. The department shall administer the fund. The fund s…
Neb. Rev. Stat. § 68-966 Department; apply for medical assistance program waiver or amendment; legislative intent.
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(1) The department shall apply for a waiver or an amendment to an existing waiver under the medical assistance program established in section 68-903 for the purpose of providing medical assistance for intensive early intervention services based on behavioral principles for childr…
Neb. Rev. Stat. § 68-967 Comprehensive treatment of pediatric feeding disorders; amendment to state medicaid plan; department; duties.
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(1) On or before July 1, 2010, the Department of Health and Human Services shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services amending the state medicaid plan to provide for medicaid payments …
Neb. Rev. Stat. § 68-968 School-based health centers; School Health Center Advisory Council; members.
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(1) To ensure that the interests of the school district, community, and health care provider are reflected within the policies, procedures, and scope of services of school-based health centers, each school district shall establish a School Health Center Advisory Council for each …
Neb. Rev. Stat. § 68-969 Amendment to medicaid state plan or waiver; children eligible for medicaid and CHIP; treatment for pregnant women; department; duties.
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(1) On or before July 1, 2010, the department shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services, amending the medicaid state plan or seeking a waiver thereto to provide for utilization of mon…
Neb. Rev. Stat. § 68-970 Nebraska Regional Poison Center; legislative findings.
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The Legislature finds that: (1) The Nebraska Regional Poison Center funded through the University of Nebraska Medical Center Cash Fund provides a valuable service to Nebraska; (2) The center receives over seventeen thousand calls annually, seventy-two percent of the calls involve…
Neb. Rev. Stat. § 68-971 Amendment to medicaid state plan or waiver; Nebraska Regional Poison Center; payments; use; department; duties; University of Nebraska Medical Center; report.
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(1) On or before January 1, 2012, the department shall submit an application to the federal Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to amend the medicaid state plan or seek a waiver to provide for utilization of the …
Neb. Rev. Stat. § 68-972 Prenatal care; legislative findings; creation of separate program; benefits provided; department; submit state plan amendment or waiver; eligibility.
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(1) The Legislature finds that: (a) Title XXI of the federal Social Security Act, as amended, and the rules and regulations promulgated pursuant thereto, authorize the State Children's Health Insurance Program to assist state efforts to initiate and expand provisions of child hea…
Neb. Rev. Stat. § 68-973 Medical assistance programs; improper payments; postpayment reimbursement; legislative findings; integrity procedures and guidelines; legislative intent.
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(1) The Legislature finds that the medical assistance program would benefit from increased efforts to (a) prevent improper payments to service providers, including, but not limited to, enforcement of eligibility criteria for recipients of benefits, enforcement of enrollment crite…
Neb. Rev. Stat. § 68-974 Program integrity contractors; contracts; contents; audit procedures; powers; health insurance premium assistance payment program; contract; department; powers and duties; form of records authorized; appeal.
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(1) One or more program integrity contractors may be used to promote the integrity of the medical assistance program, to assist with investigations and audits, or to investigate the occurrence of fraud, waste, or abuse. The contract or contracts may include services for (a) cost-…
Neb. Rev. Stat. § 68-975 Department; apply for amendment to medicaid state plan; multisystemic therapy for youth.
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(1) On or before May 1, 2016, the department shall submit an application to the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services to amend the medicaid state plan to provide for utilization of money to allow for payments for m…
Neb. Rev. Stat. § 68-976 Provider with high categorical risk level; fingerprint-based criminal history record information check; Nebraska State Patrol; issue report; cost; department; powers and duties.
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(1)(a) Any provider with a high categorical risk level as determined by the Centers for Medicare and Medicaid Services or the medicaid assistance program established pursuant to the Medical Assistance Act shall be subject to a fingerprint-based criminal history record information…
Neb. Rev. Stat. § 68-977 Ground Emergency Medical Transport Act; act, how cited.
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Sections 68-977 to 68-988 shall be known and may be cited as the Ground Emergency Medical Transport Act.
Neb. Rev. Stat. § 68-978 Terms, defined.
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For purposes of the Ground Emergency Medical Transport Act: (1) Advanced life support means special services designed to provide definitive prehospital emergency medical care, including, but not limited to, cardiopulmonary resuscitation, cardiac monitoring, cardiac defibrillation…
Neb. Rev. Stat. § 68-979 Legislative intent.
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It is the intent of the Legislature that no General Funds be used in carrying out the Ground Emergency Medical Transport Act. Revenue from the intergovernmental transfer program created under the Ground Emergency Medical Transport Act shall be deposited into the Health and Human …
Neb. Rev. Stat. § 68-980 Supplemental reimbursement.
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An eligible provider as described in section 68-981 shall, in addition to the rate of payment that the provider would otherwise receive for medicaid ground emergency medical transport services, receive supplemental reimbursement pursuant to the Ground Emergency Medical Transport …
Neb. Rev. Stat. § 68-981 Supplemental reimbursement; eligibility.
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Participation in the supplemental reimbursement program by an eligible provider is voluntary. A provider is eligible for supplemental reimbursement only if the provider has all of the following characteristics continuously during a fiscal year of the state: (1) Provides ground em…
Neb. Rev. Stat. § 68-982 Supplemental reimbursement; calculation and payment.
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(1) An eligible provider's supplemental reimbursement pursuant to the Ground Emergency Medical Transport Act shall be calculated and paid as follows: (a) The supplemental reimbursement shall not exceed the amount of federal financial participation received as a result of the clai…
Neb. Rev. Stat. § 68-983 Intergovernmental transfer program; department; powers and duties.
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(1) The department shall design and implement, in consultation with eligible providers as described in section 68-981, an intergovernmental transfer program relating to medicaid managed care ground emergency medical transport services, including services provided by emergency med…
Neb. Rev. Stat. § 68-984 Agreement.
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(1) An eligible provider, as a condition of receiving supplemental reimbursement, shall enter into and maintain an agreement with the department for purposes of implementing the Ground Emergency Medical Transport Act and reimbursing the department for the costs of administering t…
Neb. Rev. Stat. § 68-985 Governmental entity; duties.
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If a governmental entity elects to seek supplemental reimbursement pursuant to the Ground Emergency Medical Transport Act on behalf of an eligible provider owned or operated by the entity, the governmental entity shall: (1) Certify, in conformity with the requirements of 42 C.F.R…
Neb. Rev. Stat. § 68-986 Act; federal approvals; department; powers.
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(1) On or before January 1, 2026, the department may seek any necessary federal approvals for the implementation of the Ground Emergency Medical Transport Act. (2) The department may limit the program to those costs that are allowable expenditures under Title XIX of the federal S…
Neb. Rev. Stat. § 68-987 Department; powers and duties.
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(1) The department may submit claims for federal financial participation for the expenditures for the services described in subsection (2) of section 68-986 that are allowable expenditures under federal law. (2) The department may annually submit any necessary materials to the fe…
Neb. Rev. Stat. § 68-988 Increased capitation payments; commencement.
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To the extent federal approval is obtained, the increased capitation payments under section 68-983 may commence for dates of service on or after January 1, 2026.
Neb. Rev. Stat. § 68-989 Disclosure by applicant; income and assets; action for recovery of medical assistance authorized.
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(1) This section shall apply to the fullest extent permitted by federal law and understandings entered into between the state and the federal government. An applicant for medical assistance, or a person acting on behalf of the applicant, shall disclose at the time of application …
Neb. Rev. Stat. § 68-990 Medical assistance; transfers; security for recovery of indebtedness to department; lien; notice; filing; department; duties; section null and void.
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(1) For purposes of this section: (a) Related transferee means: (i) An individual who is related to the transferor as described in section 77-2004 or 77-2005; (ii) An entity controlled by one or more individuals described in subdivision (1)(a)(i) of this section. For purposes of …
Neb. Rev. Stat. § 68-991 Medical provider; authority to apply for medical assistance.
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A medical provider shall have the authority of a guardian and conservator for the limited purpose of making application for medical assistance on behalf of a person whom the provider is treating if the person is unconscious or otherwise is unable to apply for medical assistance a…
Neb. Rev. Stat. § 68-992 Eligibility for medical assistance; expanded population; Department of Health and Human Services; duties.
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(1) Eligibility for medical assistance shall be expanded to include certain adults ages nineteen through sixty-four whose income is equal to or less than one hundred thirty-eight percent of the federal poverty level, as authorized and using the income methodology defined by 42 U.…
Neb. Rev. Stat. § 68-993 Medical parole; protocol.
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The Division of Medicaid and Long-Term Care of the Department of Health and Human Services shall, in consultation with the Department of Correctional Services, develop a protocol to assist an individual who is eligible for medical parole pursuant to section 83-1,110.02 to apply f…
Neb. Rev. Stat. § 68-994 Long-term care services and supports; department; limitation on addition to medicaid managed care program; long-term care clients with special needs; medicaid managed care contracts; requirements.
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(1) Until July 1, 2023, the department shall not add long-term care services and supports to the medicaid managed care program. For purposes of this section, long-term care services and supports includes services of a skilled nursing facility, a nursing facility, and an assisted-…
Neb. Rev. Stat. § 68-995 Contracts and agreements; department; duties; contractor; mental health and substance use disorder services; requirements.
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(1) All contracts and agreements relating to the medical assistance program governing at-risk managed care service delivery for health services entered into by the department and existing on or after August 11, 2020, shall: (a) Provide a definition and cap on administrative spend…
Neb. Rev. Stat. § 68-996 Medicaid Managed Care Excess Profit Fund; created; use; investment.
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(1) The Medicaid Managed Care Excess Profit Fund is created. The fund shall contain money returned to the State Treasurer pursuant to subdivision (1)(c) of section 68-995. (2) The fund shall first be used to offset any losses under subdivision (1)(b) of section 68-995 and then to…
Neb. Rev. Stat. § 68-997 Job-skills programs; voluntary; departments; powers and duties.
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(1) Beginning October 1, 2020, the Department of Health and Human Services shall inform each adult applicant for medical assistance about job-skills programs within the Department of Health and Human Services, the Department of Labor, or other skill-based programs that could assi…
Neb. Rev. Stat. § 68-998 Managed care organization; provider contract; material change; notice.
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(1) For purposes of this section: (a)(i) Material change means a change to a provider contract, the occurrence and timing of which is not otherwise clearly identified in the provider contract, that decreases the provider's payment or compensation for services to be provided or ch…
Neb. Rev. Stat. § 68-999 Direct care staff; psychiatric facilities caring for juveniles; standards.
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The Division of Medicaid and Long-Term Care of the Department of Health and Human Services shall set standards required for direct care staff of inpatient psychiatric units for juveniles and psychiatric residential treatment facilities for juveniles. The standards shall require t…