Bill > LB1144

This bill amends existing Nebraska law to redefine what constitutes a "health plan" under the Medical Assistance Act, expanding it to include entities like service benefit plans, managed care organizations, and pharmacy benefit managers, in addition to traditional insurance policies. It also introduces new requirements for entities that issue health plans, mandating that they respond to requests from the state's Department of Health and Human Services regarding claims for health care items or services submitted within three years of the service being provided. Furthermore, these entities are prohibited from denying claims solely based on submission date, claim form type, or lack of point-of-sale documentation, as long as the claim is submitted within the three-year window and the state initiates any enforcement action within six years of the claim's submission. These changes aim to improve the coordination of benefits and streamline the process for the state to recover costs for medical assistance provided to individuals who also have other health coverage.

Health and Social Services

https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=63823