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NE LB138

Change provisions relating to pharmacy dispensing fees under the Medical Assistance Act


summary

Introduced
01/13/2025
In Committee
01/15/2025
Crossed Over
Passed
Dead

Introduced Session

109th Legislature

Bill Summary

A BILL FOR AN ACT relating to public assistance; to amend section 68-9,111, Revised Statutes Cumulative Supplement, 2024; to change pharmacy dispensing fees as prescribed; and to repeal the original section.

AI Summary

This bill modifies pharmacy dispensing fees for pharmacies participating in Nebraska's Medical Assistance program (Medicaid), introducing a tiered fee structure based on the number of annual prescriptions filled. Starting July 1, 2026, independent pharmacies (defined as owning six or fewer pharmacies) will receive $10.38 per prescription, while other pharmacies will have graduated reimbursement rates: $10.38 for pharmacies with fewer than 30,000 prescriptions per year, $9.51 for pharmacies with 30,000-70,000 prescriptions, and $8.30 for pharmacies with 70,000 or more prescriptions. The bill also includes a special provision that any pharmacy that is the sole pharmacy within a 30-mile radius will receive the highest dispensing fee of $10.38 per prescription. The Department of Health and Human Services is required to conduct a cost-of-dispensing survey by July 1, 2026, and submit a report to the Legislature with recommendations for future fee adjustments. The goal is to ensure fair and adequate reimbursement for pharmacies participating in the medical assistance program, with a particular focus on supporting independent and rural pharmacies.

Committee Categories

Health and Social Services

Sponsors (1)

Last Action

Quick name added (on 01/30/2025)

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