This bill amends section 44-4109.01 of the Reissue Revised Statutes of Nebraska, which outlines requirements for certain insurance policies and contracts. Key changes include the stipulation that policies must not exclude a provider with a practice that has a substantial number of patients with severe or expensive medical conditions, or a provider who holds a visiting faculty permit. Additionally, the bill clarifies that while insurers can exclude providers who do not meet specific criteria for quality, accessibility, or economic considerations, they cannot broadly exclude providers based on the aforementioned conditions.

The bill also emphasizes the need for transparency in insurance arrangements by requiring that prospective insured individuals receive clear and understandable information about coverage provisions, prior authorization requirements, and financial responsibilities. It mandates that insurers conduct customer satisfaction surveys and make the results available to current and potential participants. Furthermore, it establishes a structured appeal process for providers who are denied contracts or excluded from participation, ensuring they have the opportunity to contest adverse decisions through a fair hearing process. The original section 44-4109.01 is repealed as part of this legislative update.

Statutes affected:
Introduced: 44-4109.01