Bill > LB138

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.

Health and Social Services

https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=59315