[{"_1":2,"_124":-5,"_125":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100,112],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6304125,"mediaKeyId","2469039-092e8cf176428d11082e9b053235a308","parentId",2469039,"title","Committee hears bill to restore voluntary sliding fee for area agencies on aging care management","audioSeconds",502,"startMs",324000,"endMs",826000,"viewUrl","/Search/View?dp=1&key=2469039-092e8cf176428d11082e9b053235a308&start=324&end=826","thumbnailUrl","https://assets.pipeline.soar.com/2469039-092e8cf176428d11082e9b053235a308/thumbnail_324000.jpg","articleUrl","/articles/6304125/Nebraska/Committee-hears-bill-to-restore-voluntary-sliding-fee-for-area-agencies-on-aging-care-management","mediaUrl","https://secure.pipeline.soar.com/6304125-1bfd218d7b12f4932493a863024a7384/orig.mp4?Expires=1771137105&Signature=J7ZTysAtA9I-FO4BPOl51CoVebYZxsTsryWT4uSZNzWd7xSWwG4XruQjc6cwPR1xfNr~5e4smXXovnAGNHvI-Q~eMyZ2h-Ehg22ag4mYw-IFysTBG3YhSbB2ktaaP4kPDNKq87Dg~m25ci8g10C4vVw767nhRvF9isStRyd~8NfGmAIGvzvp7nTflO7ZxfBhKx5Cm3uqtp2wde7NYYIoXFwNFFMfTzOGvWCYxQbqIkBcewbGIxV1phLC2PuWEaaQ-1BOI-iUrjZWVcXITID8Jk67ETdckqiP65uB-C5Gr1vLOaI4CiRydKEwSA5J42m93WT9vt3s~QR8pVf8EqLiyw__&Key-Pair-Id=KUT5TJCACFTXG","author","Nebraska Legislature","date","2025-02-26T00:00:00Z","article","Senators and witnesses gathered at a Health and Human Services Committee hearing to consider LB603, a bill to restore a voluntary sliding fee for care-management services provided by Nebraska\u0000\u0000area agencies on aging and require the Department of Health and Human Services to pay unpaid client contributions.

Supporters said the change would restore an interpretation in place for roughly three decades and remove a barrier that led some older Nebraskans to decline services.

LB603 would amend the statutory language governing care management by clarifying that older-adult clients may make voluntary contributions according to a family-income schedule tied to federal poverty guidelines and that DHHS would cover any unpaid amounts. Proponents argued this aligns care management with Older Americans Act-funded services and helps keep people in the community rather than in assisted living or nursing facilities.

Rod Horsley, director of the South Central Nebraska Area Agency on Aging, told the committee that the area agencies on aging provide assessments and coordinate services such as home-delivered meals and transportation. Horsley said the 2018 change in DHHS\u0000policy had required some clients to pay and that many who were informed they were required to pay then declined services. Horsley said LB603 restores the voluntary-contribution approach and will allow agencies to provide services to those who cannot or will not pay.

Kirstin Reed, CEO of LeadingAge Nebraska, said the policy shift in 2018 had unintended consequences and that restoring the voluntary contribution system is a modest and cost-effective way to protect access to community-based services. Reed cited the fiscal note showing roughly $50,000 in fees collected in recent years and said that figure likely understates the program\u0000value because some clients dropped services rather than pay.

Senator Beau Ballard, the bill\u0000introducer, said the intent is to conserve public resources and keep older Nebraskans in their homes longer. He noted the program operated under the voluntary model for about 30 years before 2018.

No committee vote was recorded during the hearing. The committee was told there were four online proponent comments and no opponents or neutral comments filed for the record during the hearing.

If advanced, the bill would change statutory language and direct DHHS to reimburse area agencies for unpaid voluntary contributions, restoring the earlier administrative practice proponents described.

The committee moved on to its next agenda item after testimony concluded.","mediaType","Video","parentTitle","Health and Human Services Committee - 2/26/2025","oneSentenceSummary","Senators and witnesses gathered at a Health and Human Services Committee hearing to consider LB603, a bill to restore a voluntary sliding fee for care-management services provided by Nebraska area agencies on aging and require the Department of Health and Human Services to pay unpaid client contributions.","taxTitle","2025 Legislature NE, Nebraska","taxId",77675,"location","Nebraska","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6304106,"Committee hears bill to codify Medicaid coverage for home blood-pressure devices and clinical support",579,15826000,16405000,"/Search/View?dp=1&key=2469039-092e8cf176428d11082e9b053235a308&start=15826&end=16405","https://assets.pipeline.soar.com/2469039-092e8cf176428d11082e9b053235a308/thumbnail_15826000.jpg","/articles/6304106/Nebraska/Committee-hears-bill-to-codify-Medicaid-coverage-for-home-blood-pressure-devices-and-clinical-support","https://secure.pipeline.soar.com/6304106-a34e54d2907b5a9d2a13b1c224de652f/orig.mp4?Expires=1771137105&Signature=e937pnja601QTnRcTqGErA3Hf6GvVPJRsx2I3tLYznaf4zPOozZ0JBzR0Tf2bpKXwA8CTg5qgg2OJsDGvfXhvXtFrFFhmoNENzp0nXTQYeUWatQ7QnNTO2wKiCLPyRy3cPB5xEuk1n3BgNtci4-d1c3XX5ugwTo03WGOrnqnjKQzcbbHfl0dOs18fjHhwYz3FrCluxZW8S8JN9g9nirf~F415yyM0XO36IDq30RrDAxyStwbj2DbOdzgFcpLQ9kZH1orrd0o7b5tFa3~Oh9Vn7QclWJxq5ZRQhhgj2ij1ngpcTsrUmQAB0XDasx-wtHpb5EP93ksN-nbP8kF-6zHqQ__&Key-Pair-Id=KUT5TJCACFTXG","The Health and Human Services Committee heard testimony supporting LB365, which would codify Medicaid coverage for self-measured blood pressure (SMBP) devices and include coverage for associated clinical support services.

Sponsor Sen. Dan Quick said SMBP monitoring is endorsed by major guidelines (American Heart Association, American Medical Association) and is associated with reductions in blood pressure and better hypertension control. HB365 would explicitly allow Medicaid coverage of SMBP monitors and the clinical staff time needed to collect, review and act on those readings.

Proponents told the committee that high blood pressure is a leading cause of stroke and heart attack, and that continuous home monitoring with clinician review can identify problems early and reduce costly hospitalizations and long-term disability. Stroke survivor Jill Dueis said daily blood-pressure monitoring has been essential to her recovery and argued that preventing just a small number of strokes would offset the bill\u0000s costs.

Health advocacy groups including the American Heart Association voiced support, saying SMBP plus clinician support is evidence-based and cost-effective. Sen. Quick noted that many individuals already buy home monitors; the proposed change would ensure equitable access for Medicaid enrollees and incorporate reimbursable clinical follow-up so providers can act on the data.

No committee vote was taken. Testimony included clinicians and patient advocates urging the committee to advance the bill to support prevention and chronic-disease management among Medicaid recipients.","LB365 would codify Medicaid coverage of self-measured blood pressure devices and add coverage for clinical support services (data review/interpretation and care-team adjustments). Proponents said regular home measurement plus clinician follow-up reduces strokes and costs; sponsors and associations urged committee approval.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6304110,"Cities, fire departments back bill to let Nebraska draw federal GEMT funds for ambulance costs",2373,11974000,14347000,"/Search/View?dp=1&key=2469039-092e8cf176428d11082e9b053235a308&start=11974&end=14347","https://assets.pipeline.soar.com/2469039-092e8cf176428d11082e9b053235a308/thumbnail_11974000.jpg","/articles/6304110/Nebraska/Cities-fire-departments-back-bill-to-let-Nebraska-draw-federal-GEMT-funds-for-ambulance-costs","https://secure.pipeline.soar.com/6304110-0d2a92af0975fe2cc44796bbd7c8d3e8/orig.mp4?Expires=1771137105&Signature=N8Whf7IKcAhX8UXy0D1WcoIrExqvXjZhAIeqEDVgdE-CoHjrmt7bdbfv0stHpTs5Ky0Se8pbMyNcIAyPmLHmWaXONRFhtR4lGVTv9HA52ODDFRv2oZyBzEMybakhT19SUFV3UeRoflfPnCojG0PgHtnmGRiVF0hR82N-cwpEDfkLe~F~uB-ke95qNDxWAJfQPPYg8b84h7bpPgeAw4Lwn0wWwTsy8WCwMe5nFl7AyfzOuN0RUZeOVSe41OCEhY8qx6btWvufZzjWWFEad4BhA5jM5kq3ZFIvHW6hzn0o90PtWffaXjKghFLmEynoya8SbjK1l11BKI7xLjE0J6po6w__&Key-Pair-Id=KUT5TJCACFTXG","Members of the Health and Human Services Committee heard bipartisan support for LB610, legislation that would adjust Nebraska's Medicaid state plan language to permit supplemental federal reimbursement for ground emergency medical transport (GEMT).

Sponsor Sen. Eliot Bostar said the change would allow Nebraska to claim federal Medicaid matching funds for the reasonable cost differential between Medicaid reimbursements and the actual costs of ambulance transports. He and witnesses said the program is voluntary for local governmental providers and has been adopted by many neighboring states.

Fire chiefs, municipal leaders and hospital representatives told the committee the federal supplement would help address shortfalls in payment for ambulance transports and reduce pressure on local property-tax budgets. Lincoln Fire Chief Dave Engler and Papillion Fire Chief Rob Gottsch described high call volumes, rising equipment costs and the difficulty of maintaining staffed ambulances in a tight labor market. Chief Engler said roughly 70% of his department\u0000s transports are Medicaid or Medicare and that GEMT funds would support fleet, staffing and training improvements.

DHHS Deputy Director Jeremy Brunson testified on implementation details and said participation would be voluntary for governmental providers. He outlined the primary mechanics: participating providers would file cost reports, the state would calculate the allowable cost differential, and providers would transfer the non-federal share via an intergovernmental transfer (IGT); federal matching dollars would then be claimed and passed back as supplemental payments. Brunson said the state would not expect general-fund costs and would retain a small administration portion from the supplemental payment to cover operational costs.

Supporters also included the Nebraska Professional Firefighters Association, the Nebraska Hospital Association and volunteer firefighter groups. Some witnesses cited the 2019 collapse of a for-profit ambulance operator in rural Nebraska as an example of how fragile transport networks can become without adequate reimbursement.

The committee did not take a vote at the hearing. DHHS indicated it had worked with the sponsor on draft permissive language and a schedule for prospective implementation to meet federal rules. Proponents said the program will not be mandatory for local agencies but would provide an option to recover reasonable costs for public ambulance operations.","LB610 would amend Nebraska's Medicaid state plan language to allow supplemental federal reimbursement (GEMT) for ground emergency medical transport services. Proponents said the change would help public and volunteer EMS and reduce local taxpayer pressure; DHHS outlined implementation mechanics and said the program is voluntary for providers.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6304115,"Providers urge limits on managed-care audits and clawbacks; A.G. and DHHS warn of fraud-investigation constraints",7358,2566000,9924000,"/Search/View?dp=1&key=2469039-092e8cf176428d11082e9b053235a308&start=2566&end=9924","https://assets.pipeline.soar.com/2469039-092e8cf176428d11082e9b053235a308/thumbnail_2566000.jpg","/articles/6304115/Nebraska/Providers-urge-limits-on-managed-care-audits-and-clawbacks-AG-and-DHHS-warn-of-fraud-investigation-constraints","https://secure.pipeline.soar.com/6304115-e0736d0e96fd18e6fd7850e61694bef6/orig.mp4?Expires=1771137106&Signature=n0VCEH~krpNiEhWv~B~aKJQLIkKD~wiosD9KvCZjMdQVuCF2PKiZPdaFe2cPDqaGTiRQ2aWltOFHPCC0lZkFkbA1JKvJa7Yoa0eF~L44VkFSn39droKRxCQySQ9sUrFZO5-sXEj24LY-wUpqab8PypaPI8lN80nI76Uh4tVnS3VFE881WlueGClCOc7P3zUBKyNbxfzWzCxE3egVKNfWfidO~p-lPfH1cJlV4U3UO3vi5fYBhEEbfH9w6oTlU-9u~iUEa2Fk2QNNMRHGCATFdhLuMMOhGqV~0IXWsLhjOSEl0iJRZ1VVb--ReaL3Q1ek4fjEASv4XqMuO~GrRl7blQ__&Key-Pair-Id=KUT5TJCACFTXG","More than a dozen behavioral-health clinicians and several provider groups told the Health and Human Services Committee that Nebraska Medicaid contractors have conducted prolonged and aggressive audits that leave small practices facing large clawbacks and limited appeal remedies. LB381, introduced by Sen. John Frederickson, would impose time and process guardrails on MCO audits.

Under LB381 proponents asked for written justification for audits, a 180-day completion requirement for contractors, a one-year limit on audit lookbacks except in cases of fraud, limits on the number and scope of record requests, and clearer appeals protections so contractors cannot recover payments until appeals are exhausted.

Several licensed practitioners described audits that requested hundreds of records, demanded tens of thousands of dollars in repayment, and took months or years to resolve. Therapist Drew McMillan said audits he faced lasted 12 months and produced a demand for $20,000 in repayment; another practitioner said audits resulted in more than $1 million in recoupment across dozens of providers. Providers described audits done by nonclinical reviewers, denials of informal consultations and NDAs that prevented transparency.

Supporters included the Nebraska Psychological Association, the National Association of Social Workers\u0000Nebraska chapter and county-level providers. Mary Kelly of the League of Women Voters cited surveys showing many counties lack mental-health providers and said aggressive audit practices risk further shrinking the provider network. Witnesses said audits have driven clinicians to stop accepting Medicaid or to close practices.

The Department of Health and Human Services and the Nebraska Attorney General\u0000Medicaid Fraud and Patient Abuse Unit opposed or raised concerns. DHHS said LB381 would limit the department's ability to perform federally-required program-integrity work and noted the federal government requires extended lookback periods in some audit programs. The AG's Medicaid fraud unit said fraud investigations often require more than a year of review and that a one-year cap could hinder criminal and civil enforcement.

Committee members pressed DHHS and the AG about oversight and appeals procedures and expressed concern at accounts of delayed audits and poor communication. Several senators said they expected DHHS to follow up on providers' reports of inadequate communication and training.

The hearing did not include a committee vote. Proponents filed dozens of written comments and many clinicians gave in-person accounts; DHHS and the attorney general asked legislators to avoid changes that might hamper detection and prosecution of Medicaid fraud.","At a second hearing related to managed care, LB381 drew extensive testimony from behavioral-health clinicians who described prolonged audits, large retroactive clawbacks and appeal difficulties. The attorney general\u0000and DHHS said a one-year lookback or other limits could impair fraud investigations and federal compliance.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6304120,"Bill to strengthen Medicaid managed-care oversight draws broad provider support, DHHS raises concerns",3453,898000,4351000,"/Search/View?dp=1&key=2469039-092e8cf176428d11082e9b053235a308&start=898&end=4351","https://assets.pipeline.soar.com/2469039-092e8cf176428d11082e9b053235a308/thumbnail_898000.jpg","/articles/6304120/Nebraska/Bill-to-strengthen-Medicaid-managed-care-oversight-draws-broad-provider-support-DHHS-raises-concerns","https://secure.pipeline.soar.com/6304120-e96988a1a7a4134e727d9e19097e0335/orig.mp4?Expires=1771137106&Signature=htzh4o9qdDV~vTuIELiJ9MhpXTW7Z-pDMbbBoRDZtd0XvWdDHPaIzvUGsySn22hAbK~0uoqa~7M6cvRpG2vQ4hBtztMsnrNVmjzVcO65w5vg89OMygQahhyfGFhZGqdrdGT6762wItZe-H0G6XcHhytFQZKEgguqNZ34TqnA-zbyKKDct8l2rLKFeZMfC7oO0SsBSrpUouVZHbUzx0s5qAlJNtj8AOByF~xAauRwjmPMm9YsrYcruf40490JKQf2a1vlv7r3dnanqyDTCzOUz9LcRSL8~8uOzPTn389LD1Rln0Qc71ycwYJknofkyL2PLK8jtqxSg7VWaWfFUfaztA__&Key-Pair-Id=KUT5TJCACFTXG","The Health and Human Services Committee heard extensive testimony on LB380, a bill introduced by Sen. John Frederickson to tighten statutory oversight of Nebraska\u0000Medicaid managed-care organizations (MCOs), with proponents arguing the measure is needed to protect providers and patients and opponents warning of unintended operational consequences.

LB380 would add explicit statutory expectations for MCOs, requiring that Medicaid providers be paid at rates set or funded by the Legislature, that contract changes be communicated to providers, and that MCOs maintain parity between behavioral and physical health services, make utilization-review policies public and comply with generally accepted standards of care.

Supporters included the Nebraska Association of Behavioral Health Organizations (NABHO), the Council of Autism Service Providers, Nebraska Counseling Association and individual behavioral-health clinicians. Annette Dubas, executive director of NABHO, told the committee that providers have seen lower reimbursement and needed statutory clarity so the legislature\u0000and DHHS know what is expected in contracts. Mike Wasmer of the Council of Autism Service Providers said LB380 would prevent MCOs from cutting rates for applied behavior analysis (ABA) services and would push for stronger network adequacy standards.

Providers from rural Nebraska described difficulties contracting with three different MCOs and inconsistent communications. Kristen Rose, a mental-health practitioner in Sidney, said clinicians are sometimes paid less than negotiated or posted rates and that limited provider networks are a particular problem in rural counties.

DHHS Deputy Director Dree Wgon Shorowski testified in opposition, saying LB380 would restrict MCOs\u0000ability to negotiate contracted rates and could prevent MCOs from applying medical-necessity criteria for behavioral health services. DHHS also raised confidentiality concerns about some reporting requirements and said that network adequacy is already addressed in MCO contracts with the division.

The Nebraska Association of Medicaid Health Plans and the Medicaid plan trade group also testified, urging caution on measures that would limit MCOs' contracting flexibility, noting MCOs negotiate above and below fee-for-service rates as part of broader cost-efficiency strategies.

Senators pressed both sides with questions about whether the legislature should set a floor for negotiated rates, how to balance rate consistency with competitive contracting, and whether current audit and appeals processes are adequate for providers. Several providers described aggressive audits and clawbacks under separate testimony (heard later on LB381), which helped build momentum for statutory protections in LB380 proponents' testimonies.

No committee vote occurred at the hearing. Proponents filed written comments numbering in the dozens; DHHS and plan representatives asked for a collaborative path forward and noted potential drafting changes to focus the bill on behavioral health reimbursement and communication practices rather than broad rate mandates.","Senators heard proponents urge LB380 to require greater transparency and statutory guardrails for managed care organizations, especially on rates, parity and network adequacy. DHHS and MCO trade groups warned the bill could limit contractual negotiation and add reporting burdens.","actionData","errors"]

Article not found

Committee hears bill to restore voluntary sliding fee for area agencies on aging care management

Committee hears bill to codify Medicaid coverage for home blood-pressure devices and clinical support

Cities, fire departments back bill to let Nebraska draw federal GEMT funds for ambulance costs

Providers urge limits on managed-care audits and clawbacks; A.G. and DHHS warn of fraud-investigation constraints

Bill to strengthen Medicaid managed-care oversight draws broad provider support, DHHS raises concerns