The resolution proposes an interim study to evaluate the performance and policies of managed care organizations (MCOs) involved in Nebraska's medical assistance program, which serves a large portion of Medicaid beneficiaries, including low-income residents, children, seniors, and individuals with disabilities. The study aims to address concerns raised by health care providers, patient advocates, and beneficiaries regarding the transparency, timeliness, and consistency of MCO processes that may impact access to necessary medical care. Key areas of focus for the study will include prior authorization processes, coding and downcoding practices, and the overall structure and effectiveness of contracting with the three managed care organizations currently in place.

The Health and Human Services Committee of the Nebraska Legislature is tasked with conducting this interim study and will be responsible for reporting its findings and recommendations to the Legislative Council or the Legislature upon completion. The resolution emphasizes the importance of ensuring that the managed care system operates effectively and meets the needs of its beneficiaries while maintaining accountability and cost-effectiveness.