Healthcare (Prescription Drugs)

died · Nebraska · Legislature Apr 17, 2026

LB 138: Change provisions relating to pharmacy dispensing fees under the Medical Assistance Act

Nebraska's LB 138 changes how pharmacies are paid for dispensing prescriptions under Medicaid. Starting July 1, 2026, independent pharmacies (owning six or fewer locations) and pharmacies as the only option within 30 miles will receive $10.38 per prescription. Other pharmacies will receive tiered fees based on annual prescription volume: $10.38 for under 30,000 prescriptions, $9.51 for 30,000-70,000, and $8.30 for 70,000+ prescriptions. The bill requires the state to conduct cost surveys every two years and adjust fees annually to ensure fair reimbursement for all participating pharmacies.

Topics ✓ HealthcareSupports HealthcareSets higher Medicaid pharmacy fees for independent/rural pharmacies to maintain access, strengthening provider reimbursement under public health program.90% confidence

Sub-Topics Prescription Drugs

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died · Nebraska · Legislature Apr 17, 2026

LB 252: Prohibit disadvantaging insurance and Medicaid coverage for nonopioid drugs

Nebraska's LB 252 prohibits Medicaid and commercial insurers from disadvantaging nonopioid pain medications approved by the FDA. It requires that such drugs receive equal coverage terms compared to opioid alternatives, banning higher cost-sharing tiers, stricter prior authorization, or step therapy requirements for nonopioid drugs. The law applies immediately upon FDA approval for pain treatment and mandates exceptions for providers who confirm nonopioid drugs are appropriate for a patient. This directly affects insurers (including Medicaid managed care organizations), healthcare providers, and patients seeking pain management options. The bill aims to ensure equal access to nonopioid treatments without restricting prescribers' choices.

Topics ✓ HealthcareSupports HealthcareMandates equal insurance coverage for nonopioid pain meds, removing financial barriers and improving patient access to alternatives without restricting options.95% confidence

Sub-Topics Prescription Drugs Substance Abuse

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died · Nebraska · Legislature Apr 17, 2026

LB 158: Provide requirements for health carriers or pharmacy benefit managers regarding out-of-pocket maximums and cost-sharing requirements

LB 158 requires Nebraska health insurance plans and pharmacy benefit managers to count all payments made by patients (or others on their behalf) toward their annual out-of-pocket maximum. This includes copays, deductibles, and costs for services like prescriptions, ensuring all such payments reduce the yearly limit patients must pay before full coverage kicks in. The law applies to new or renewed health plans after January 1, 2026, with a limited exception for health savings accounts that must first meet a minimum deductible before counting toward the maximum (though preventive care always counts). It directly affects health plan enrollees by clarifying how their out-of-pocket costs are calculated.

Topics ✓ HealthcareSupports HealthcareRequires health plans to count all patient payments (copays, deductibles) toward out-of-pocket max, reducing patient financial burden and improving access to coverage before full benefits kick in.95% confidence

Sub-Topics Prescription Drugs Primary Care

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died · Nebraska · Legislature Apr 17, 2026

LB 533: Provide requirements relating to clinician-administered drugs under the Pharmacy Benefit Manager Licensure and Regulation Act

This bill adds specific requirements for "clinician-administered drugs" (outpatient drugs that cannot be self-administered and must be given in clinics, hospitals, or similar settings by a healthcare provider) under Nebraska's Pharmacy Benefit Manager (PBM) regulations. It requires specialty pharmacies shipping these drugs to provide 24/7 pharmacist/nurse access, allow refill requests through PBMs/health plans, and comply with federal drug tracking rules. The bill also mandates that PBMs or health plans must establish a clear appeal process for providers if drugs aren't delivered on time or if urgent care is needed to prevent immediate harm. These changes directly affect specialty pharmacies, PBMs, and healthcare providers administering these drugs, effective January 2026.

Topics ✓ HealthcareSupports HealthcareRequires PBMs to provide 24/7 clinician access and streamline refills for clinician-administered drugs, improving patient access to essential medications under PBM regulations.85% confidence

Sub-Topics Healthcare Workforce Medical Licensing Prescription Drugs

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signed · Nebraska · Legislature Apr 10, 2025

LB 168: Adopt the 340B Contract Pharmacy Protection Act

Nebraska's LB 168 (signed April 9, 2025) adopts the 340B Contract Pharmacy Protection Act to protect access to federally discounted drugs. It prohibits drug manufacturers from restricting 340B drug deliveries to authorized locations (like contract pharmacies) or demanding extra data (such as patient records) beyond federal requirements. The law directly affects safety-net hospitals, clinics, and other 340B entities that rely on discounted drugs, as well as drug manufacturers and distributors. It ensures these providers can continue using 340B discounts without unnecessary barriers imposed by manufacturers.

Topics ✓ HealthcareSupports HealthcareProtects access to federally discounted drugs for safety-net providers, strengthening healthcare access under 340B program by prohibiting restrictions on contract pharmacies.95% confidence

Sub-Topics Prescription Drugs

died · Nebraska · Legislature Apr 17, 2026

LB 109: Prohibit certain provisions in insurance policies and health plans relating to clinician-administered drugs and change provisions relating to pharmacy benefit managers

Nebraska's LB 109 prohibits health insurers and pharmacy benefit managers (PBMs) from imposing restrictions that limit patient access to clinician-administered drugs - such as those given in a doctor's office or clinic rather than a pharmacy. It bans insurers from charging extra fees, requiring specific pharmacy use, or denying coverage when drugs are administered by healthcare providers. The bill also requires PBMs to allow pharmacists to discuss treatment options, costs, and alternatives with patients and prohibits penalizing pharmacies for sharing information about their practices. These changes directly affect insurers, health plans, and PBMs in how they handle drug coverage and patient communications.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from restricting clinician-administered drugs and extra fees, directly improving patient access to treatments without coverage denials or pharmacy mandates.95% confidence

Sub-Topics Prescription Drugs Primary Care

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signed · Nebraska · Legislature Jun 6, 2025

LB 198: Change provisions of the Pharmacy Benefit Manager Licensure and Regulation Act

LB 198 amends Nebraska's Pharmacy Benefit Manager (PBM) regulations to directly affect specialty pharmacies, pharmacists, and PBMs. It prohibits PBMs from excluding accredited specialty pharmacies from their networks and bans "spread pricing" (where PBMs charge health plans different prices than they pay pharmacies for drugs). The bill also allows network pharmacists to decline to dispense a drug as prescribed and updates definitions for terms like "clinician-administered drugs" and "specialty pharmacy." These changes aim to increase transparency, protect pharmacy access, and clarify PBM obligations under state law.

Topics ✓ HealthcareSupports HealthcareBans spread pricing and prohibits PBM exclusion of specialty pharmacies, improving drug access/transparency. Allows pharmacists to decline unsafe prescriptions, protecting patient safety and provider rights.90% confidence

Sub-Topics Medical Licensing Prescription Drugs