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LEGISLATURE OF NEBRASKA
ONE HUNDRED NINTH LEGISLATURE
SECOND SESSION
LEGISLATIVE BILL 1016
Introduced by Raybould, 28; Spivey, 13.
Read first time January 13, 2026
Committee: Health and Human Services
A BILL FOR AN ACT relating to the Medical Assistance Act; to amend1
section 68-901, Revised Statutes Cumulative Supplement, 2024; to2
state intent; to require the Department of Health and Human Services3
to submit a demonstration project waiver application for4
reimbursement of traditional healing services under the medical5
assistance program as prescribed; and to repeal the original6
section. 7
Be it enacted by the people of the State of Nebraska,8
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Section 1. Section 68-901, Revised Statutes Cumulative Supplement,1
2024, is amended to read: 2
68-901 Sections 68-901 to 68-9,111 and sections 2 to 6 of this act3
shall be known and may be cited as the Medical Assistance Act.4
Sec. 2. (1) The Legislature finds that: (a) Health inequities5
persist among American Indian and Alaska Native populations and other6
underserved communities within the State of Nebraska; (b) culturally7
grounded and community-based approaches to health care, including8
traditional healing practices, have demonstrated value in supporting9
physical, mental, emotional, and spiritual well-being; (c) section 111510
of the Social Security Act authorizes the Secretary of the United States11
Department of Health and Human Services to approve experimental, pilot,12
or demonstration projects that promote the objectives of the medicaid13
program; and (d) meaningful consultation with tribal nations is required14
under federal law and is essential to government-to-government15
relationships and effective health policy. 16
(2) The purpose of sections 2 to 6 of this act is to authorize the17
department to seek federal approval to test the reimbursement of18
traditional healing services under the medical assistance program in a19
manner that improves access to culturally appropriate care, advances20
health equity, and complies with medicaid requirements.21
Sec. 3. (1) No later than July 1, 2026, the department shall22
develop and apply to the federal Centers for Medicare and Medicaid23
Services for approval of a demonstration project waiver pursuant to24
section 1115 of the Social Security Act to allow for reimbursement of25
traditional healing services under the medical assistance program. If the26
department has not submitted the demonstration project waiver application27
by July 1, 2026, the department shall, on or before such date, submit a28
report to the Health and Human Services Committee of the Legislature29
stating the reasons for the delay, the status of consultation, and the30
anticipated submission date. 31
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(2) The demonstration project shall be designed to: (a) Improve1
health outcomes and access to care for medicaid beneficiaries through2
culturally appropriate services; (b) test the effectiveness of3
traditional healing services as a complement to existing covered medicaid4
services; (c) maintain budget neutrality and program integrity in5
accordance with federal law and guidance; and (d) maximize available6
federal financial participation, including enhanced federal matching7
funds where available, consistent with federal law and guidance.8
Sec. 4. (1) For purposes of sections 2 to 6 of this act,9
traditional healing services means culturally grounded practices that10
support health and well-being, as defined by the department in11
consultation with tribal nations, tribal health authorities, and urban12
Indian organizations as defined in 25 U.S.C. 1603, as such section13
existed on January 1, 2026. 14
(2) Traditional healing services authorized under the demonstration15
project shall: (a) Be voluntary for medicaid beneficiaries; (b) not16
replace or restrict access to otherwise covered medicaid services; and17
(c) be delivered by providers meeting eligibility criteria established by18
the department and approved by the federal Centers for Medicare and19
Medicaid Services. 20
Sec. 5. (1) The department shall engage in consultation with tribal21
nations and urban Indian organizations as defined in 25 U.S.C. 1603, as22
such section existed on January 1, 2026, prior to submission of the23
demonstration project waiver application and throughout the24
implementation and evaluation of the demonstration project.25
(2) Consultation shall include, but not be limited to: (a)26
Development of service definitions and provider eligibility criteria; (b)27
design of reimbursement methodologies; (c) evaluation measures and28
reporting requirements; and (d) confidentiality protections and29
safeguards to ensure that participation does not require disclosure of30
culturally protected or sacred knowledge consistent with applicable state31
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and federal law. 1
(3) Nothing in sections 2 to 6 of this act shall be construed to2
waive tribal sovereignty, alter federal Indian health authorities, or3
diminish the federal trust responsibility. 4
Sec. 6. (1) The department shall adopt and promulgate rules and5
regulations to administer the demonstration project, subject to approval6
by the federal Centers for Medicare and Medicaid Services, including7
provisions related to reimbursement, utilization controls, data8
collection, and reporting. 9
(2) The department shall include an evaluation component as required10
under section 1115 of the Social Security Act to assess the impact of the11
demonstration project on health outcomes, access to care, utilization,12
and cost effectiveness, and shall report findings as required by federal13
law. 14
(3) Implementation of sections 2 to 6 of this act is contingent upon15
approval of the demonstration project waiver by the federal Centers for16
Medicare and Medicaid Services. 17
Sec. 7. Original section 68-901, Revised Statutes Cumulative18
Supplement, 2024, is repealed. 19
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