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LEGISLATURE OF NEBRASKA
ONE HUNDRED NINTH LEGISLATURE
SECOND SESSION
LEGISLATIVE BILL 950
Introduced by Bostar, 29.
Read first time January 09, 2026
Committee: Banking, Commerce and Insurance
A BILL FOR AN ACT relating to insurance; to amend sections 81-6,123,1
81-6,125, 81-6,127, and 81-6,128, Reissue Revised Statutes of2
Nebraska, and section 44-5437, Revised Statutes Supplement, 2025; to3
change provisions relating to uniform prior authorization request4
forms as prescribed; to change requirements for the designated5
health information exchange; to change duties of the Health6
Information Technology Board; to harmonize provisions; and to repeal7
the original sections. 8
Be it enacted by the people of the State of Nebraska,9
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Section 1. Section 44-5437, Revised Statutes Supplement, 2025, is1
amended to read: 2
44-5437 (1)(a) On or before November 1, 2025, the department shall3
approve a single uniform prior authorization request form for4
prescription drugs, devices, and durable medical equipment and a single5
uniform prior authorization request form for all other health care6
services. The uniform prior authorization request forms shall not exceed7
two printed pages in length. This two-page limit does not apply to8
information or documentation required by the utilization review agent, as9
published in accordance with subsection (1) of section 44-5434, or a10
health care provider's notes or documentation submitted in support of a11
prior authorization request. 12
(b) Beginning January 1, 2026 , except as provided in subsection (2)13
of this section, (i) health care providers shall use only the approved14
uniform prior authorization request forms; and (ii) utilization review15
agents shall accept and process prior authorization requests submitted16
using such forms. : 17
(i) All health care providers shall use only the approved uniform18
prior authorization request forms; and 19
(ii) Except as provided in subsection (2) of this section, all20
utilization review agents shall accept and process prior authorization21
requests submitted using such forms. 22
(c) This subsection does not prohibit a utilization review agent23
from using a prior authorization methodology that uses an Internet24
webpage, an Internet webpage portal, or a similar web-based system if the25
methodology is consistent with the uniform prior authorization request26
forms approved by the department pursuant to this subsection.27
(2)(a) (2) A utilization review agent may request from the28
department an exemption from the requirements of subsection (1) of this29
section if the utilization review agent implements and maintains a prior30
authorization application programming interface pursuant to 45 C.F.R.31
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156.223(b) or other electronic prior authorization methodology that1
automates and standardizes the prior authorization process for patients,2
health care providers, and health carriers. A utilization review agent3
shall provide notice to health care providers at least ninety days prior4
to implementing a prior authorization application programming interface5
or other electronic prior authorization methodology under this6
subsection. 7
(b) Within ninety days after the date of receipt of the notice8
described in subdivision (2)(a) of this section, a health care provider9
shall use only the prior authorization application programming interface10
or other approved electronic prior authorization methodology for prior11
authorization requests. Upon a request from a health care provider, a12
utilization review agent may grant an extension of time for good cause.13
Sec. 2. Section 81-6,123, Reissue Revised Statutes of Nebraska, is14
amended to read: 15
81-6,123 Sections 81-6,123 to 81-6,128 81-6,126 shall be known and16
may be cited as the Population Health Information Act.17
Sec. 3. Section 81-6,125, Reissue Revised Statutes of Nebraska, is18
amended to read: 19
81-6,125 (1) The purpose of the Population Health Information Act is20
to designate a health information exchange to provide the data21
infrastructure needed to assist in creating a healthier Nebraska and22
operating the electronic health records initiative.23
(2) The designated health information exchange shall:24
(a) Aggregate clinical information from health care entities needed25
to support the operation of the medical assistance program under the26
Medical Assistance Act; 27
(b) Act as the designated entity for purposes of access to and28
analysis of health data; 29
(c) Collect and analyze data for purposes of informing the30
Legislature, the department, health care providers, and health care31
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entities as to the cost of, access to, and quality of health care in1
Nebraska; 2
(d) Act as a collector and reporter of public health data for3
registry submissions, electronic laboratory reporting, immunization4
reporting, and syndromic surveillance from an electronic health record,5
which does not include claims data; and 6
(e) Enable any health care provider or health care entity to real7
time access information available within the designated health8
information exchange to evaluate and monitor care and treatment of a9
patient in accordance with the privacy and security provisions set forth10
in the federal Health Insurance Portability and Accountability Act of11
1996, Public Law 104-191. 12
(3)(a) On or before January 1, 2027 September 30, 2021, each health13
care facility listed in subdivision (b) of this subsection shall14
participate in the designated health information exchange through sharing15
of clinical information. Such clinical information shall include the16
clinical data that the health care facility captured in its existing17
electronic health record as permitted by state and federal laws, rules,18
and regulations. Any patient health information shared with the19
designated health information exchange as determined by the rules and20
regulations policies adopted by the Health Information Technology Board21
shall be provided in accordance with the privacy and security provisions22
set forth in the federal Health Insurance Portability and Accountability23
Act of 1996 and regulations adopted under the act.24
(b) This subsection applies to an ambulatory surgical center, a25
critical access hospital, a general acute hospital, a health clinic, a26
hospital, an intermediate care facility, a long-term care hospital, a27
mental health substance use treatment center, a PACE center, a pharmacy,28
a psychiatric or mental hospital, a public health clinic, or a29
rehabilitation hospital, as such terms are defined in the Health Care30
Facility Licensure Act, or a diagnostic, laboratory, or imaging center.31
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(c) This subsection does not apply to (i) a state-owned or state-1
operated facility or (ii) an assisted-living facility, a nursing2
facility, or a skilled nursing facility, as such terms are defined in the3
Health Care Facility Licensure Act. 4
(d) Any connection established by July 1, 2021, between a health5
care facility and the designated health information exchange to6
facilitate such participation shall be at no cost to the participating7
health care facility. 8
(e) A health care facility may apply to the board for a waiver from9
the requirement to participate under this subsection due to a10
technological burden. The board shall review the application and11
determine whether to waive the requirement. If the board waives the12
requirement for a health care facility, the board shall review the waiver13
annually to determine if the health care facility continues to qualify14
for the waiver. 15
(e) (f) The board shall not require a health care facility to16
purchase or contract for an electronic records management system or17
service. 18
(4)(a) On or before January 1, 2022, each health insurance plan19
shall participate in the designated health information exchange through20
sharing of information. Subject to subsection (5) of this section, such21
information shall be determined by rules and regulations policies adopted22
by the Health Information Technology Board. Such information shall not23
include claims data or any other data used for billing, payment, or24
adjudication purposes. 25
(b) For purposes of this subsection: 26
(i) Health insurance plan includes any group or individual sickness27
and accident insurance policy, health maintenance organization contract,28
subscriber contract, employee medical, surgical, or hospital care benefit29
plan, or self-funded employee benefit plan to the extent not preempted by30
federal law; and 31
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(ii) Health insurance plan does not include (A) accident-only,1
disability-income, hospital confinement indemnity, dental, hearing,2
vision, or credit insurance, (B) coverage issued as a supplement to3
liability insurance, (C) insurance provided as a supplement to medicare,4
(D) insurance arising from workers' compensation provisions, (E)5
automobile medical payment insurance, (F) insurance policies that provide6
coverage for a specified disease or any other limited benefit coverage,7
or (G) insurance under which benefits are payable with or without regard8
to fault and which is statutorily required to be contained in any9
liability insurance policy. 10
(5) The designated health information exchange and the department11
shall enter into an agreement to allow the designated health information12
exchange to collect, aggregate, analyze, report, and release de-13
identified data, as defined by the federal Health Insurance Portability14
and Accountability Act of 1996, that is derived from the administration15
of the medical assistance program. Such written agreement shall be16
executed no later than September 30, 2021. 17
(6) In addition to the right to opt out as provided in section18
71-2454, an individual shall have the right to opt out of the designated19
health information exchange or the sharing of information required under20
subsections (3) and (4) of this section. The designated health21
information exchange shall adopt a patient opt-out rules and regulations22
policy consistent with the federal Health Insurance Portability and23
Accountability Act of 1996 and other applicable federal requirements.24
Such rules and regulations policy shall not apply to mandatory public25
health reporting requirements. 26
Sec. 4. Section 81-6,127, Reissue Revised Statutes of Nebraska, is27
amended to read: 28
81-6,127 (1) The Health Information Technology Board is created. The29
board shall have seventeen members. Except for members designated in30
subdivision (2)(o) of this section, the members shall be appointed by the31
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Governor with the approval of a majority of the members of the1
Legislature. The members may begin to serve immediately following2
appointment and prior to approval by the Legislature. The members shall3
be appointed by February 1, 2021, and the board shall begin meeting on or4
before April 1, 2021. 5
(2) Members designated under subdivisions (b), (c), (d), (e), (g),6
(h), and (i) of this subsection shall hold a credential under the Uniform7
Credentialing Act. Except as otherwise provided in subsection (4) of this8
section, the board shall consist of: 9
(a) One individual who has experience in operating the prescription10
drug monitoring program created under section 71-2454;11
(b) Two physicians, one of whom shall be a family practice12
physician, who are in active practice and in good standing with the13
Department of Health and Human Services appointed from a list of14
physicians provided by a statewide organization representing physicians;15
(c) One pharmacist who is in active practice and in good standing16
with the department appointed from a list of pharmacists provided by a17
statewide organization representing pharmacists; 18
(d) One alcohol and drug counselor providing services for a state-19
licensed alcohol and drug abuse addiction treatment program;20
(e) One health care provider who is board-certified in pain21
management; 22
(f) One hospital administrator appointed from a list of hospital23
administrators provided by a statewide organization representing hospital24
administrators; 25
(g) One dentist who is in active practice and in good standing with26
the department appointed from a list of dentists provided by a statewide27
organization representing dentists; 28
(h) One nurse practitioner who is in active practice and in good29
standing with the department authorized to prescribe medication appointed30
from a list of nurse practitioners authorized to prescribe medication31
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provided by a statewide organization representing such nurse1
practitioners; 2
(i) One veterinarian who is in active practice and in good standing3
with the department appointed from a list of veterinarians provided by a4
statewide organization representing veterinarians; 5
(j) Two representatives One representative of the Department of6
Health and Human Services including one representative from the Division7
of Medicaid and Long-Term Care of the Department of Health and Human8
Services; 9
(k) One representative of a delegate as defined in section 71-2454;10
(l) One health care payor as defined in section 25-21,247 or an11
employee of a health care payor; 12
(m) One credentialed health information management professional13
appointed from a list of such professionals provided by a statewide14
organization representing such professionals; 15
(n) One representative of the statewide health information exchange16
described in section 71-2455; and 17
(o) The chairperson of the Health and Human Services Committee of18
the Legislature and the chairperson of the Appropriations Committee of19
the Legislature, both of whom are nonvoting, ex officio members; and .20
(p) One representative of an insurer, as defined in section 44-103,21
who offers at least one health insurance plan as defined in section22
81-6,125. 23
(3) Except for members designated in subdivisions (2)(a) and (o) of24
this section: 25
(a) A minimum of three members shall be appointed from each26
congressional district; 27
(b) Each member shall be appointed for a five-year term beginning on28
April 1, 2021, and may serve for any number of such terms;29
(c) Any member appointed prior to April 1, 2021, shall begin to30
serve immediately upon appointment and continue serving for the term31
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beginning on April 1, 2021; and 1
(d) Any vacancy in membership, other than by expiration of a term,2
shall be filled within ninety days by the Governor by appointment for the3
vacant position as provided in subsection (2) of this section.4
(4) If, after appointment, the classification of a member's5
credential changes or a member's credential classification is terminated6
and if such credential was a qualification for appointment, the member7
shall be permitted to continue to serve as a member of the board until8
the expiration of the term for which appointed unless the member loses9
the credential due to disciplinary action. 10
(5) The members shall be reimbursed for their actual and necessary11
expenses incurred in serving on the board as provided in section 71-2455.12
(6) A simple majority of members shall constitute a quorum for the13
transaction of all business. 14
Sec. 5. Section 81-6,128, Reissue Revised Statutes of Nebraska, is15
amended to read: 16
81-6,128 (1) The Health Information Technology Board shall:17
(a) Establish criteria for data collection and disbursement by the18
statewide health information exchange described in section 71-2455 and19
the prescription drug monitoring program created under section 71-2454 to20
improve the quality of information provided to clinicians;21
(b) Evaluate and ensure that the statewide health information22
exchange is meeting technological standards for reporting of data for the23
prescription drug monitoring program, including the data to be collected24
and reported and the frequency of data collection and disbursement;25
(c) Provide the governance oversight necessary to ensure that any26
health information in the statewide health information exchange and the27
prescription drug monitoring program may be accessed, used, or disclosed28
only in accordance with the privacy and security protections set forth in29
the federal Health Insurance Portability and Accountability Act of 1996,30
Public Law 104-191, and regulations promulgated thereunder. All protected31
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health information is privileged, is not a public record, and may be1
withheld from the public pursuant to section 84-712.05; and2
(d) Provide recommendations to the statewide health information3
exchange on any other matters referred to the board.4
(2) The board shall adopt and promulgate rules and regulations5
policies and procedures necessary to carry out the Population Health6
Information Act its duties. 7
(3) The authority of the board to direct the use or release of data8
under this section or section 71-2454 shall apply only to requests9
submitted to the board after September 1, 2021. 10
(4) The board may hold meetings by telecommunication or electronic11
communication subject to the Open Meetings Act. Any official action or12
vote of the members of the board shall be preserved in the records of the13
board. 14
(5) By November 15, 2021, and November 15 of each year thereafter,15
the board shall develop and submit an annual report to the Governor and16
the Health and Human Services Committee of the Legislature regarding17
considerations undertaken, decisions made, accomplishments, and other18
relevant information. The report submitted to the Legislature shall be19
submitted electronically. 20
Sec. 6. Original sections 81-6,123, 81-6,125, 81-6,127, and21
81-6,128, Reissue Revised Statutes of Nebraska, and section 44-5437,22
Revised Statutes Supplement, 2025, are repealed. 23
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