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LEGISLATURE OF NEBRASKA
ONE HUNDRED NINTH LEGISLATURE
SECOND SESSION
LEGISLATIVE BILL 1143
Introduced by Hardin, 48.
Read first time January 20, 2026
Committee: Appropriations
A BILL FOR AN ACT relating to public assistance; to amend section 68-949,1
Revised Statutes Cumulative Supplement, 2024; to provide for2
modification of the appropriation to the Department of Health and3
Human Services for medicaid nursing facility rates based on client4
service utilization as prescribed; to require the department to5
submit an application to establish a Money Follows the Person6
program; and to repeal the original section. 7
Be it enacted by the people of the State of Nebraska,8
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Section 1. Section 68-949, Revised Statutes Cumulative Supplement,1
2024, is amended to read: 2
68-949 (1) It is the intent of the Legislature that the department3
implement reforms to the medical assistance program such as those4
contained in the Medicaid Reform Plan, including (a) an incremental5
expansion of home and community-based services for aged persons and6
persons with disabilities consistent with such plan, (b) an increase in7
care coordination or disease management initiatives to better manage8
medical assistance expenditures on behalf of high-cost recipients with9
multiple or chronic medical conditions, and (c) other reforms as deemed10
necessary and appropriate by the department, in consultation with the11
committee. 12
(2) The department shall develop recommendations based on a13
comprehensive analysis of various options available to the state under14
applicable federal law for the provision of medical assistance to persons15
with disabilities who are employed, including persons with a medically16
improved disability, to enhance and replace current eligibility17
provisions contained in subdivision (8) of section 68-915.18
(3) The department shall develop recommendations for further19
modification or replacement of the defined benefit structure of the20
medical assistance program. Such recommendations shall be consistent with21
the public policy in section 68-905 and shall consider the needs and22
resources of low-income Nebraska residents who are eligible or may become23
eligible for medical assistance, the experience and outcomes of other24
states that have developed and implemented such changes, and other25
relevant factors as determined by the department. 26
(4)(a) It is the intent of the Legislature that the total amount27
appropriated to the department for medicaid nursing facility rates be28
identified as a dollar amount in the state budget and be used in the29
medicaid nursing facility rate calculation, including the calculation of30
the annual inflation factor. The total amount appropriated for medicaid31
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nursing facility rates shall include amounts for rate enhancement and any1
other purpose related to medicaid nursing facility services and shall be2
used as the base for funding for the following fiscal year. The3
department may take into consideration utilization relating to client4
needs and preferred setting when establishing nursing facility rates for5
prospective rating periods. If the department uses an amount that differs6
from the identified appropriation in the calculation of nursing facility7
rates for the prospective rate period, such dollar amount and the number8
of projected nursing facility resident days used in the calculation shall9
be identified to the Legislature in the report required under subdivision10
(4)(b) of this section. 11
(b) The department shall file a report electronically with the12
Legislative Fiscal Analyst and the Clerk of the Legislature no later than13
August 1 of each year identifying how the inflation factor was calculated14
for that year's medicaid nursing facility rates and including the15
information described in subdivision (4)(a) of this section.16
(c) The department shall file a report electronically with the17
Legislative Fiscal Analyst and the Clerk of the Legislature between18
December 15 and December 31 of each year identifying the amount of any19
remaining unobligated appropriation from the prior appropriations20
earmarked for medicaid nursing facility payments. The report shall21
include an identification of encumbrances and retroactive payments.22
(5) No later than December 31, 2026, the department shall submit an23
application to the federal Centers for Medicare and Medicaid Services to24
establish a money follows the person program to assist qualified25
individuals to transition from an institutional setting to a community26
setting while continuing to receive long-term care.27
Sec. 2. Original section 68-949, Revised Statutes Cumulative28
Supplement, 2024, is repealed. 29
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