Bill Summary – FastDemocracy

LB22                                                                                  LB22
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                                 LEGISLATURE OF NEBRASKA
                              ONE HUNDRED NINTH LEGISLATURE
                                      FIRST SESSION
                         LEGISLATIVE BILL 22
       Introduced by Dungan, 26.
       Read first time January 09, 2025
       Committee:
   A BILL FOR AN ACT relating to the Medical Assistance Act; to amend
       sections 68-911 and 68-996, Revised Statutes Cumulative Supplement,
       2024; to require the Department of Health and Human Services to file
       a state plan amendment for evidenced-based nurse home visiting
       services as prescribed; to state intent relating to funding; and to
       repeal the original sections.
   Be it enacted by the people of the State of Nebraska,
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       Section 1. Section 68-911, Revised Statutes Cumulative Supplement,
   2024, is amended to read:
       68-911 (1) Medical assistance shall include coverage for health care
  and related services as required under Title XIX of the federal Social
  Security Act, including, but not limited to:
      (a) Inpatient and outpatient hospital services;
      (b) Laboratory and X-ray services;
      (c) Nursing facility services;
      (d) Home health services;
      (e) Nursing services;
      (f) Clinic services;
      (g) Physician services;
      (h) Medical and surgical services of a dentist;
      (i) Nurse practitioner services;
      (j) Nurse midwife services;
      (k) Pregnancy-related services;
      (l) Medical supplies;
      (m) Mental health and substance abuse services;
      (n)    Early and periodic screening and diagnosis and treatment
   services for children which shall include both physical and behavioral
   health screening, diagnosis, and treatment services;
       (o) Rural health clinic services; and
       (p) Federally qualified health center services.
       (2) In addition to coverage otherwise required under this section,
   medical assistance may include coverage for health care and related
   services as permitted but not required under Title XIX of the federal
   Social Security Act, including, but not limited to:
       (a) Prescribed drugs;
       (b)   Intermediate care facilities for persons with developmental
   disabilities;
       (c) Home and community-based services for aged persons and persons
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LB22                                                                                             LB22
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  with disabilities;
         (d) Dental services;
         (e) Rehabilitation services;
         (f) Personal care services;
         (g) Durable medical equipment;
         (h) Medical transportation services;
         (i) Vision-related services;
         (j) Speech therapy services;
         (k) Physical therapy services;
         (l) Chiropractic services;
         (m) Occupational therapy services;
         (n) Optometric services;
         (o) Podiatric services;
         (p) Hospice services;
         (q) Mental health and substance abuse services;
         (r) Hearing screening services for newborn and infant children; and
         (s) Administrative expenses related to administrative activities,
  including outreach services, provided by school districts and educational
  service units to students who are eligible or potentially eligible for
  medical assistance.
         (3) No later than July 1, 2009, the department shall submit a state
  plan amendment or waiver to the federal Centers for Medicare and Medicaid
  Services to provide coverage under the medical assistance program for
  community-based secure residential and subacute behavioral health
   services for all eligible recipients,   without regard to   whether the
  recipient has been ordered by a mental health board under the Nebraska
  Mental Health Commitment Act to receive such services.
         (4) On or before October 1, 2014, the department, after consultation
  with the State Department of   Education,   shall submit    a state plan
  amendment to the federal Centers for Medicare and Medicaid Services, as
  necessary, to provide that the following are direct reimbursable services
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  when provided by school districts as part of an individualized education
  program or an individualized family service plan: Early and periodic
  screening,      diagnosis,    and treatment services for children;     medical
   transportation services;       mental health services;      nursing services;
   occupational therapy services; personal care services; physical therapy
   services; rehabilitation services; speech therapy and other services for
  individuals with speech, hearing, or language disorders; and vision-
  related services.
      (5)(a) No later than January 1, 2023, the department shall provide
  coverage for continuous glucose monitors under the medical assistance
  program for all eligible recipients who have a prescription for such
  device.
       (b) Effective August 1, 2024, eligible recipients shall include all
   individuals who meet local coverage determinations, as defined in section
  1869(f)(2)(B) of the federal Social Security Act, as amended, as such act
  existed on    January     1,    2024,     and shall include individuals with
  gestational diabetes.
      (c) It is the intent of the Legislature that no more than six
  hundred thousand dollars be   appropriated annually from the Medicaid
  Managed Care Excess Profit Fund, as described in section 68-996, for the
   purpose of implementing subdivision (5)(b) of this section. Any amount in
  excess of six hundred thousand dollars shall be funded by the Medicaid
  Managed Care Excess Profit Fund.
      (6) On or before October 1, 2023, the department shall seek federal
  approval for federal matching funds from the federal Centers for Medicare
  and Medicaid Services through a state plan amendment or waiver to extend
  postpartum coverage for beneficiaries from sixty days to at least six
   months. Nothing in this subsection shall preclude the department from
   submitting a state plan amendment for twelve months.
      (7)(a) No later than October 1, 2025, the department shall submit a
  medicaid waiver or   state plan amendment to    the federal Centers for
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   Medicare and Medicaid Services to    designate two medical respite
   facilities to reimburse for services provided to an individual who is:
       (i) Homeless; and
       (ii) An adult in the expansion population.
       (b) For purposes of this subsection:
      (i) Adult in the expansion population means an adult (A) described
  in 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) as such section existed on January
   1, 2024, and (B) not otherwise eligible for medicaid as a mandatory
   categorically needy individual;
      (ii) Homeless has the same meaning as provided in 42 U.S.C. 11302 as
  such section existed on January 1, 2024;
       (iii) Medical respite care means short-term housing with supportive
   medical services; and
       (iv)     Medical respite facility means     a residential facility that
   provides medical respite care to homeless individuals.
      (c) The department shall choose two medical respite facilities, one
   in a city of the metropolitan class and one in a city of the primary
   class, best able to serve homeless individuals who are adults in the
   expansion population.
       (d)    Once such waiver or   state plan amendment is    approved,   the
   department shall submit    a report to    the Health and Human Services
   Committee of the Legislature on or before November 30 each year, which
   provides the (i) number of homeless individuals served at each facility,
   (ii) cost of the program, and (iii) amount of reduction in health care
   costs due to the program's implementation.
      (e) The department may adopt and promulgate rules and regulations to
  carry out this subsection.
       (f) The services described in subdivision (7)(a) of this section
   shall be funded by the Medicaid Managed Care Excess Profit Fund as
   described in section 68-996.
       (8)(a) No later than January 1, 2025, the department shall provide
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LB22                                                                                                 LB22
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  coverage for an electric personal-use breast pump for every pregnant
   woman covered under the medical assistance program, or child covered
  under the medical assistance program if     the pregnant woman is   not
   covered, beginning at thirty-six weeks gestation or the child's date of
   birth, whichever is earlier. The electric personal-use breast pump shall
   be capable of (i) sufficiently supporting milk supply, (ii) double and
   single side pumping, and (iii) suction power ranging from zero mmHg to
   two hundred fifty mmHg. No later than January 1, 2025, the department
   shall provide coverage for a minimum of ten lactation consultation visits
  for every mother covered under the medical assistance program or child
   covered under the medical assistance program,       if the mother is   not
   covered under such program.
        (b) It is the intent of the Legislature that the appropriation for
  lactation consultation visits shall be equal to an amount that is a one
   hundred forty-five percent rate increase over the current lactation
   consultation rate paid by the department.
        (9)(a) No later than January 1, 2024, the department shall provide
   coverage, and reimbursement to providers, for all necessary translation
   and interpretation services for eligible recipients utilizing a medical
  assistance program service.     The department shall take all actions
  necessary to maximize federal funding to carry out this subsection.
         (b) The services described in subdivision (9)(a) of this section
   shall be funded by the Medicaid Managed Care Excess Profit Fund as
   described in section 68-996.
        (10)(a) No later than October 1, 2025, the department shall seek
   approval for federal matching funds from the federal Centers for Medicare
   and Medicaid Services through      a state plan amendment to     implement
   targeted case management for evidence-based nurse home visiting services.
  These services shall consist of visits to a home by a nurse and be
  available to postpartum mothers and children younger than three years of
   age enrolled in medicaid or the Children's Health Insurance Program.
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LB22                                                                                                       LB22
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          (b) It is the intent of the Legislature to use the Medicaid Managed
   Care Excess Profit Fund established in     section      68-996     to fund the
   services described in subdivision (a) of this subsection.
          Sec.    2.     Section    68-996,     Revised Statutes Cumulative Supplement,
   2024, is amended to read:
          68-996 (1) The Medicaid Managed Care Excess Profit Fund is created.
   The fund shall contain money returned to the State Treasurer pursuant to
   subdivision (3) of section 68-995.
          (2)    The fund shall first be   used to     offset any losses under
   subdivision (2) of section 68-995 and then to provide for (a) services
   addressing the health needs of adults and children under the Medical
   Assistance Act, including filling service gaps, (b) providing system
   improvements,         (c)     providing evidence-based early intervention home
   visitation programs,        (d)     providing medical respite services,     (e)
   translation and interpretation services,      (f)      providing coverage for
   continuous glucose monitors as described in section 68-911, (g) providing
   other services sustaining access to care, (h) the Nebraska Prenatal Plus
   Program, (i) and providing grants pursuant to the Intergenerational Care
   Facility Incentive Grant Program,       and    (j)    evidence-based nurse home
   visiting services as determined by the Legislature. The fund shall only
   be used for the purposes described in this section.
          (3) Any money in the fund available for investment shall be invested
   by the state investment officer pursuant to    the Nebraska Capital
   Expansion Act and the Nebraska State Funds Investment Act. Beginning
   October 1, 2024, any investment earnings from investment of money in the
   fund shall be credited to the General Fund.
          Sec.    3.         Original sections    68-911      and     68-996,    Revised Statutes
   Cumulative Supplement, 2024, are repealed.
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Statutes affected: 
Introduced: 68-911, 68-996