The Nebraska State Legislature introduced Legislature Bill 264 on January 17, 2025, aiming to expand medical assistance coverage under the state's Medicaid program. The bill seeks to provide comprehensive coverage for community-based secure residential and subacute behavioral health services for all eligible recipients, regardless of whether they have been mandated by a mental health board to receive such services.

Key provisions of the bill include a requirement for the Nebraska Department of Health and Human Services to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services. This amendment would ensure that various services, such as early screening, diagnosis, treatment for children, and mental health services provided by school districts, are reimbursable under Medicaid. Additionally, the bill mandates coverage for continuous glucose monitors for eligible recipients with prescriptions, including those with gestational diabetes, starting August 1, 2024.

The bill has sparked notable discussions among lawmakers, particularly regarding its financial implications. The Legislature intends to limit appropriations from the Medicaid Managed Care Excess Profit Fund to no more than $600,000 annually for the implementation of the glucose monitor coverage. This financial cap has raised concerns among some legislators about the sustainability of funding for the expanded services.

Supporters of the bill argue that it addresses critical gaps in mental health and diabetes care, potentially improving health outcomes for vulnerable populations. However, opponents express worries about the potential strain on state resources and the long-term viability of funding these expanded services.

As the bill progresses through the legislative process, its implications could significantly impact Nebraska's healthcare landscape, particularly for individuals requiring behavioral health services and those managing diabetes. The outcome of this legislation will be closely monitored, as it may set a precedent for future healthcare policy in the state.