Bill > LB380

This bill proposes several changes to Nebraska's Medical Assistance Act, focusing on program integrity, ground emergency medical transport, and mental health and substance use disorder services. The bill modifies program integrity audit procedures, including requiring program integrity contractors to provide clear written justification for audits, limit review periods to three years, and offer detailed explanations of adverse determinations. For ground emergency medical transport services, the bill updates various implementation dates and federal approval processes, shifting some mandatory requirements to permissive language. The bill also introduces new requirements for Medicaid managed care contractors, such as restricting administrative spending to 12%, capping profits, and establishing more stringent standards for mental health and substance use disorder service coverage. Specifically, contractors must maintain adequate provider networks, avoid restrictive treatment limitations, and apply criteria based on recognized care standards. Additionally, the Division of Medicaid and Long-Term Care is given new responsibilities, including ensuring provider access, establishing communication systems with healthcare providers, defining network adequacy, and publicly reporting compliance metrics. These changes aim to improve oversight, transparency, and quality of medical assistance services in Nebraska.

Health and Social Services

https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=59347