This bill amends section 44-4109.01 of the Reissue Revised Statutes of Nebraska, introducing new requirements for certain insurance policies and contracts. Key changes include the stipulation that prospective insured individuals must receive clear and understandable information about their insurance arrangements, including coverage provisions, prior authorization requirements, and financial responsibilities. Additionally, the bill mandates that customer satisfaction survey results be made available to current and potential participants, and establishes a mechanism for a committee of preferred providers to advise on medical policy and credentialing processes.

Furthermore, the bill specifies that all policies must include a credentialing system for preferred providers, allowing them to apply for credentials annually. It also outlines the appeal process for providers who are denied contracts or excluded from participation, ensuring they have the opportunity to contest adverse decisions. Notably, the bill prohibits insurance arrangements from excluding providers with a substantial number of patients with severe medical conditions or those holding a visiting faculty permit, while still allowing exclusions based on quality, accessibility, or economic criteria. The original section 44-4109.01 is repealed as part of this legislative update.

Statutes affected:
Introduced: 44-4109.01