Health and Human Services Committee
February 26, 2025
Committee Chair: Sen. Senator Merv Riepe (Vice Chair); Senator Matt Hardin (Chair for later bills) | Bills Heard: 5 | Full Transcript (PDF)
LB603: Restore voluntary contribution system for Area Agencies on Aging care management services
Introduced by: Sen. Beau Ballard | Testimony: 2 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Area Agencies on Aging seek return to voluntary fee system for care management services. LB603 would restore a 30-year-old policy allowing older Nebraskans to voluntarily contribute to care management costs rather than face mandatory payment requirements. Why it matters: The 2018 policy shift requiring mandatory fees caused many seniors to drop services, potentially forcing them into costlier institutional care. Restoring voluntary contributions could keep more older Nebraskans in their homes while reducing Medicaid expenses. What they're saying: Proponents argue the voluntary system aligns with federal Older Americans Act policy and that the 2018 change was a misinterpretation of statute. The fiscal note shows only $50,000 in annual fees collected—a negligible amount compared to the cost of nursing home care. By the numbers: Eight Area Agencies on Aging serve thousands of Nebraskans; the fiscal note projects $50,000 in foregone revenue. What's next: No vote was taken. The bill received four online proponents and zero opponents.
Committee sentiment: Supportive: Sen. Fredrickson
Sentiment estimated from questions and comments — not stated positions.
LB380: Strengthen oversight and transparency requirements for Medicaid managed care organizations
Introduced by: Sen. John Fredrickson | Testimony: 54 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Behavioral health providers demand statutory protections against aggressive managed care practices. LB380 would require MCOs to pay legislatively-approved rates, communicate contract changes, ensure mental health parity, and prohibit rescinding authorizations after services are rendered. Why it matters: Providers across Nebraska report being paid below contracted rates without explanation, facing aggressive audits months or years after services were approved, and losing access to appeals processes. Many are abandoning Medicaid entirely, worsening rural health care deserts. What they're saying: Proponents argue MCOs are distributing state dollars and must follow legislative intent on rates. A Flatwater Free Press investigation found 28 providers victimized by audits conflating minor errors with fraud; 20% of surveyed providers plan to leave Medicaid. DHHS opposes the bill, arguing it restricts cost-control mechanisms and introduces undefined terms. By the numbers: 54 online proponents, zero opponents. Behavioral health rates were 7-35% below cost in 2016; 87% of Nebraska counties lack adequate ABA providers. What's next: No vote was taken. Senator Fredrickson indicated willingness to clarify language regarding which services are covered.
Committee sentiment: Supportive: Sen. Meyer, Sen. Quick, Sen. Ballard Unclear: Sen. Riepe
Sentiment estimated from questions and comments — not stated positions.
LB381: Establish guardrails for Medicaid program integrity audits of behavioral health providers
Introduced by: Sen. John Fredrickson | Testimony: 51 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Behavioral health providers seek protection from aggressive Medicaid audits. LB381 would establish guardrails for program integrity audits, including 180-day completion deadlines, one-year lookback limits, written justification requirements, and prohibition on recovery until appeals are exhausted. Why it matters: Providers report audits initiated years after services were approved, clawbacks of $20,000-$100,000+ for clerical errors, and non-clinicians making clinical judgments. Many are abandoning Medicaid, worsening rural health care access. What they're saying: Proponents argue audits are predatory and designed to force repayment, not identify fraud. A survey found 85% of clinicians would reduce or end Medicaid relationships. DHHS and the AG's office oppose the bill, arguing the one-year lookback prevents fraud detection and creates federal compliance costs. The AG noted fraud requires 5-10 year lookback periods. By the numbers: 51 online proponents, one opponent. Over $1 million in clawbacks from 40+ audits of small practices. What's next: No vote was taken. Senator Fredrickson indicated the bill explicitly allows fraud investigations and that other states have similar protections while still prosecuting fraud.
Committee sentiment: Supportive: Sen. Meyer, Sen. Quick, Sen. Hardin Unclear: Sen. Hansen
Sentiment estimated from questions and comments — not stated positions.
LB610: Implement Ground Emergency Medical Transport (GEMT) supplemental payment program for public EMS providers
Introduced by: Sen. Eliot Bostar | Testimony: 4 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
EMS providers seek federal supplemental payment program to bridge reimbursement gap. LB610 would enable Nebraska to participate in the federal GEMT program, allowing public ambulance services to submit cost reports and receive supplemental payments for unreimbursed expenses. Why it matters: Medicare and Medicaid reimburse only 20-30% of actual EMS costs. Public providers cannot turn down 911 calls, forcing local taxpayers to subsidize the gap. Private ambulance services are closing; some areas have no ground transport options, forcing expensive helicopter use. What they're saying: Proponents note 23 neighboring states already participate in GEMT. The program is cost-neutral to Nebraska's General Fund; federal CMS reimburses actual costs. Lincoln Fire Chief testified 70% of transports are Medicare/Medicaid, creating multi-million dollar deficit. A Columbus hospital physician warned that without GEMT, Nebraska may have no private ambulance services within five years. By the numbers: GEMT estimated to provide $15-30 million to local departments. Mean EMS response cost is $1,845; mean reimbursement is $975. What's next: No vote was taken. Senator Bostar indicated DHHS previously opposed the bill but no longer does. Amendment makes participation permissive and updates implementation date to 2026.
Committee sentiment: Supportive: Sen. Riepe, Sen. Meyer, Sen. Hansen, Sen. Ballard, Sen. Fredrickson
Sentiment estimated from questions and comments — not stated positions.
LB365: Expand Medicaid coverage of self-measured blood pressure monitoring to include clinical support services
Introduced by: Sen. Dan Quick | Testimony: 8 proponents, 1 opponents, 0 neutral | Read bill text (PDF)
Blood pressure monitoring bill aims to prevent strokes through Medicaid coverage expansion. LB365 would codify Medicaid coverage of self-measured blood pressure devices and add coverage for clinical support services—physician review of patient readings to guide treatment decisions. Why it matters: Nearly half of Americans over 20 have high blood pressure with no symptoms. Uncontrolled hypertension increases stroke and heart attack risk. Preventing just 2-3 strokes would cover the bill's cost; strokes cost $30,000-$120,000 each. What they're saying: Proponents cite American Heart Association endorsement of SMBP monitoring for diagnosis and management. A stroke survivor testified that daily monitoring allowed her physician to modify treatment and prevent complications. An EMS veteran noted the approach helps patients understand symptoms and provides baseline vitals. One senator questioned whether average consumers can afford an $80 blood pressure cuff and expressed concern about Medicaid expansion. By the numbers: Eight online proponents, one opponent. High blood pressure projected to increase from 51.2% to 61% of population by 2050. What's next: No vote was taken. Senator Quick indicated willingness to address questions about prescription requirements and data transmission to physicians.
Committee sentiment: Supportive: Sen. Quick Skeptical: Sen. Riepe
Sentiment estimated from questions and comments — not stated positions.
Session Notes
The committee heard five bills on February 26, 2025. Vice Chair Fredrickson opened the hearing with procedural instructions. The hearing was lengthy, running past 5 p.m., with extensive testimony on LB380 and LB381 regarding managed care organization practices. Multiple testifiers reported aggressive audits, clawbacks for clerical errors, and lack of transparency from MCOs. Senator Meyer expressed particular frustration with DHHS's defense of the status quo and lack of accountability. The committee received 54 online proponents for LB380 and 51 for LB381. LB603 received four online proponents. LB610 received four online proponents with no opposition. LB365 received eight online proponents and one opponent. No votes were taken on any bills during the hearing.
Generated by NE Wire Service | Source: Nebraska Legislature Transcribers Office This is an AI-generated summary. Verify all claims against the official transcript.