Interim study to review the performance and policies of managed care organizations in the medical assistance program

This legislative resolution directs the Nebraska Health and Human Services Committee to conduct an interim study of managed care organizations that administer Medicaid services for low-income residents, children, seniors, and disabled individuals. The study will examine three main areas: prior authorization processes including approval times and appeal procedures, coding and downcoding practices that affect provider reimbursement, and the overall structure of contracts with the three managed care organizations currently in use. The committee will review how these organizations handle claims, use artificial intelligence in coding decisions, and manage patient stays, then submit findings and recommendations to the Legislature. This action does not change existing laws but establishes a review process to address concerns about transparency, timeliness, and consistency in healthcare administration.