Session Review: Health and Human Services
The Health and Human Services Committee advanced measures this session to improve access to health care, broaden public benefit eligibility and reduce licensure burdens for health professionals.
Medicaid
LB22, sponsored by Sen. George Dungan of Lincoln and passed 47-0, requires implementation of an evidence-based, ongoing home visiting program for postpartum mothers and infants younger than 6 months who are enrolled in Medicaid.
The state Department of Health and Human Services is required to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services by Oct. 1 to implement the voluntary program. Associated costs that are not covered by federal funds will be paid through the Medicaid Managed Care Excess Profit Fund. The use of state general funds to carry out the bill’s provisions is prohibited.
The measure also includes provisions of Lincoln Sen. Jane Raybould’s LB104. Those provisions define evidence-based home visiting programs and require DHHS to submit three annual reports, beginning Feb. 15, 2026, on the use of home visitation services in the state.
Lawmakers also approved a bill that establishes new requirements for behavioral health contract service providers, managed care organizations and Medicaid integrity audits.
LB380, introduced by Sen. John Fredrickson of Omaha, adds requirements for DHHS regarding behavioral health contract services and places restrictions on contractors through the state’s managed care organizations.
The bill requires the DHHS Division of Medicaid and Long-Term Care to define network adequacy and contractor compliance with federal and state laws for coverage of mental health and substance use disorders. Among other provisions, it also requires establishment of a monthly electronic communication system with all Medicaid providers and annual posting on the DHHS website of criteria that the division uses to assess network adequacy of each MCO.
Under the measure, managed care organizations are prohibited from limiting mental health and substance use disorder coverage more than other conditions and from revoking authorization for such services after a provider has rendered them, among other provisions.
The bill includes portions of LB381, also introduced by Fredrickson, which seek to improve transparency and oversight in Nebraska’s Medicaid auditing system.
Among other requirements, the provisions require program integrity contractors to provide clear justification for an audit and provide an appeals process. The measure also prohibits recovery of overpayments before all appeals are exhausted except in cases involving a credible allegation of fraud, limits claim reviews to within three years from the date of payment and limits record requests to relevant documents proportional to the services being audited.
Also included are provisions of Lincoln Sen. Eliot Bostar’s LB610, which allow DHHS to seek federal approval for implementation of the Ground Emergency Medical Transport Act.
Senators voted 48-1 to pass LB380.
LB365, sponsored by Sen. Dan Quick of Grand Island, would expand Nebraska Medicaid coverage for self-measured blood pressure monitoring to include clinical support services. The measure was advanced to general file but not scheduled for debate this session.
Public benefits
Income eligibility guidelines for the Supplemental Nutrition Assistance Program in Nebraska were expanded in 2021 from 130% of the federal poverty level to 165%. That expansion was scheduled to expire Oct. 1. LB192, sponsored by Quick and passed 41-8, eliminates the sunset date and retains the current income eligibility level.
The measure also includes provisions of LB656, introduced by Omaha Sen. Bob Andersen, which prohibit DHHS from seeking, applying for or renewing a work requirement waiver for SNAP benefits unless expressly required to do so by federal law. The bill also gives the department the discretion to require all eligible SNAP recipients to participate in the existing employment and training program.
Gov. Jim Pillen vetoed a bill to eliminate the state’s lifetime ban on SNAP eligibility for individuals with certain drug-related convictions.
Currently, individuals with one or more felony convictions involving the sale or distribution of a controlled substance or three or more felony convictions for possession or use are prohibited from receiving SNAP benefits.
An individual with one or two felony convictions for possession or use is eligible only if they participate in an approved substance abuse treatment program.
LB319, sponsored by Sen. Victor Rountree of Bellevue, would have removed the lifetime ban and allowed individuals with felony drug convictions to receive SNAP benefits if they otherwise qualified and had completed their sentence or were serving a term of parole, probation or post-release supervision.
The measure also would have modified the requirement to participate in a treatment program as a condition of eligibility. Under the bill, an individual with three or more felony convictions for possession or use of a controlled substance would have been eligible only after participating in an approved treatment program while incarcerated or on probation or parole following their most recent conviction.
An exception from mandatory substance abuse treatment could have been granted on a case-by-case basis if a licensed health care practitioner determined such treatment was not required.
LB319 passed on a 32-17 vote.
In his veto letter, the governor said the bill contained “loopholes” that could allow “habitual offenders” to evade the substance abuse treatment requirement. An attempt to override the veto failed on a 24-24 vote. Thirty votes were needed.
The maximum amount of time a qualifying family could receive cash assistance under the Aid to Dependent Children Program would decrease under a bill considered by the committee.
LB379, as introduced by Andersen, would reduce the lifetime maximum that a family could qualify for the program from 60 months to 24 months. A pending committee amendment instead would decrease maximum program eligibility to 36 months.
The measure was placed on general file but not scheduled for debate this session.
Children and families
A bill intended to provide support services to at-risk Omaha youth and their families was approved by lawmakers this session on a 27-21 vote.
LB48, sponsored by Omaha Sen. Terrell McKinney, creates the five-year Family Resource and Juvenile Assessment Center Pilot Program to provide culturally relevant services to family and youth involved in or at risk of entering the juvenile justice system.
The bill requires DHHS to designate two centers within a metropolitan class city to provide 24/7 support services, including youth counseling, parenting support, job training, conflict resolution and substance abuse treatment. Omaha is the state’s only metropolitan class city.
Senators also passed a bill to reform the use of Social Security benefits received by eligible Nebraska foster children.
Current Nebraska law allows DHHS to apply for Social Security benefits on behalf of eligible state wards and act as their representative payee. The department then is authorized to use a portion of those funds to reimburse the state for the foster youth’s care.
Among other reforms, LB275, sponsored by Sen. Megan Hunt of Omaha, requires the department to conserve at least 20% of all Social Security benefits in a separate trust fund, beginning when a foster child is 14 years old. The percentage will gradually increase as the child ages until reaching 50% for beneficiaries who are 18 and older.
The bill also allows an adult known to the foster child to serve as their Social Security representative payee and requires the department to use all available Title IV-E funding prior to the use of state general funds for a beneficiary’s care.
LB275 passed on a 29-19 vote.
A bill that seeks to change how child care providers are reimbursed under the state’s Child Care Subsidy Program remains on select file.
Under current Nebraska law, DHHS reimburses participating providers based on a child’s attendance with funds from the federal Child Care and Development Block Grant. LB13, introduced by Omaha Sen. Machaela Cavanaugh, instead would require the department to reimburse child care subsidy providers based on a child’s enrollment or authorized hours.
Licensure
LB84, sponsored by Rountree and approved on a 46-0 vote, adopts the School Psychologist Interstate Licensure Compact. Under the compact, which is not yet in effect, a licensed school psychologist who wishes to move into a member state may use their existing license as evidence that they are qualified to receive licensure in the member state.
Under LB257, introduced by Quick and passed 46-3, DHHS is required to issue a license to a marriage and family therapist if that individual has a valid, independent and unrestricted license in another state or territory and has passed the Nebraska jurisprudence examination.
The bill includes provisions of Hunt’s LB274. Those provisions require that entities licensed under the Child Care Licensing Act in Nebraska maintain the required level of liability insurance for any time period during which a child is in the licensee’s care.
Provisions of LB630, sponsored by Sen. Ben Hansen of Blair, also are included in the measure. Those provisions expand the scope of practice for occupational therapists and occupational therapy assistants in Nebraska.
A bill that seeks to provide certified nurse-midwives with full practice authority was advanced to select file but not scheduled for further debate this session.
Currently, certified nurse-midwives who are authorized to practice in Nebraska may do so only in a hospital or birthing center and under the supervision of a licensed practitioner.
LB676, introduced by Hansen, would remove the requirement that a CNM have a practice agreement with a collaborating licensed practitioner. The bill also would eliminate location restrictions on where a CNM may perform authorized medical functions and update the Nebraska Hospital-Medical Liability Act to include certified nurse-midwives.
Other measures
Under LB332, as introduced by Gering Sen. Brian Hardin, DHHS is required to provide Medicaid coverage for psychology services provided by qualified advanced-level practitioners who are supervised by a licensed psychologist.
The bill was amended to include provision of five additional bills heard by the committee this session:
• LB119, also sponsored by Hardin, which codifies the Rural Health Opportunity Program in state law;
• LB154, introduced by Hardin, which changes provisions related to hearing instrument specialists;
• LB515, sponsored by Quick, which provides requirements for certain prescription refills;
• LB555, introduced by Ralston Sen. Merv Riepe, which creates the position of assistant funeral director under the Funeral Directing and Embalming Practice Act; and
• LB697, sponsored by Sen. Paul Strommen of Sidney, which changes requirements relating to compounding and delegated dispensing permits under the Pharmacy Practice Act.
The bill passed on a vote of 49-0 and took effect immediately.
LB382, sponsored by Sen. Glen Meyer of Pender and approved on a 48-1 vote, expands permissible uses of the Medicaid Managed Care Excess Profit Fund to include reimbursement for the cost of services provided by the eight Nebraska Area Agencies on Aging.
The bill appropriates $2 million in fiscal year 2025-26 and FY2026-27 from the fund to be used for eligible activities under the Nebraska Community Aging Services Act, distributed equally to each of the agencies.
LB217, introduced by Fredrickson and passed 47-1, requires DHHS to develop suicide awareness and prevention training for child welfare staff, foster care providers and child-placing agency employees. All qualified staff are required to complete the training prior to any independent contact with youth and families and annually thereafter.
LB312, sponsored by Strommen and approved on a 46-1 vote, adds nurse anesthetists to the list of health professions that qualify for the Rural Health Systems and Professional Incentive Act. The act requires participants to practice in a designated health profession shortage area in Nebraska for three years to qualify for the incentive.
Under the bill, a newly eligible nurse anesthetist may receive repayment for qualified educational debts up to $15,000 annually for three years. The measure includes provisions of Riepe’s LB553, which add dietician nutritionists as qualified health professionals who are eligible for the program.
Senators also passed LB376, introduced by the Health and Human Services Committee, which updates and eliminates certain reporting requirements, including several related to Medicaid, youth rehabilitation and treatment centers, behavioral health services, newborn hearing tests, work and education programs, handgun purchase disqualifications, prenatal care and child welfare expenditures.
The bill also provides a sunset date of June 30, 2028, for a current requirement that Nebraska counties maintain offices and service facilities for the administration of public assistance programs at no cost to the department.
The measure was approved on a 47-1 vote.
Under current Nebraska law, hospitals must have a policy in place regarding the disposition of fetal remains following a miscarriage or stillbirth.
LB632, as introduced by Hansen, would require a health care facility that performs an “elective abortion” to dispose of the remains by burial, cremation or as directed by the State Board of Health. The bill does not include penalties for noncompliance.
Lawmakers advanced LB632 to select file but it was not scheduled for further debate.
Finally, LB512, sponsored by Sen. Rick Holdcroft of Bellevue, would create the Chemical Abortion Safety Protocol Act to establish additional regulations for medications used to induce abortions through a chemical process rather than through surgery.
Under the bill as introduced, a physician would be required to verify a pregnancy through an in-person examination, determine if the patient has an ectopic pregnancy, document gestational age and perform Rh factor screening before providing abortion-inducing medication.
A pending committee amendment would remove all provisions relating to Rh factor testing and treatment.
LB512 was advanced to general file by the committee but was not scheduled for debate this session.
