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Nebraska bill LB 55 would bridge Medicare–Medicaid payment gap for some behavioral health providers
Summary
LB 55 would use targeted state funds (proposed $1.5M) to cover the difference between Medicare and Medicaid reimbursement for dual‑eligible behavioral health clients after a Medicare credentialing change halved payments to certain providers, witnesses told the Appropriations Committee.
A change in Medicare credentialing has created a payment coordination issue that Nebraska behavioral‑health providers say is forcing them to choose between serving low‑income, dual‑eligible clients and taking a substantial financial loss. LB 55 would appropriate $1.5 million from the hospital quality assurance and access assessment fund (or other available sources) to restore prior Medicaid‑level payment for those dual‑eligible clients.
Senator Myron Dorn introduced LB 55, explaining that in 2024 Medicare began credentialing licensed independent mental health practitioners and marriage/family therapists as Medicare providers; when Medicare is primary the Medicare rate is substantially lower…
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