Bill > LB1222

This bill mandates that by January 1, 2027, insurance policies and self-funded employee benefit plans (to the extent not restricted by federal law) must cover medically necessary treatments for acquired brain injuries, which are defined as brain injuries occurring after birth due to various causes like infections, strokes, or traumatic events. This coverage cannot have lifetime or annual limits that contradict accepted medical standards and must treat inpatient rehabilitation limitations separately from post-acute rehabilitation services like outpatient day treatment or community reintegration. Furthermore, the bill requires an expedited appeal process for denials of acquired brain injury services, with decisions made within five business days, and ongoing rehabilitation coverage must continue during an appeal if interrupting it risks regression. The Department of Insurance will oversee compliance and report annually on coverage decisions and denials. Additionally, by January 1, 2028, insurance policies, self-funded plans, and the state's Medicaid program (medical assistance program) must cover medically necessary diagnostic testing and treatments or medications approved by the Food and Drug Administration (FDA) that are prescribed to slow the progression of Alzheimer's disease and related dementias, and this coverage cannot be subject to "step-therapy," a requirement that patients try less expensive treatments first.

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https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=63761