ACTION ALERT: SUPPORT LB 380 with AM 728 and AM 814

Why Support LB 380?

LB 380 is essential legislation designed to enhance Medicaid oversight while ensuring fair treatment for healthcare providers and recipients. The proposed amendments , AM 728 and AM 814, include important related elements of LB 381 which strengthen this bill by implementing critical reforms that benefit Nebraska constituents.

Key Benefits of LB 380 with AM 728 and AM 814:

✅ Increases Financial Accountability: Caps administrative spending at 12% and profit at 3%, directing more funds toward patient care.

✅ Strengthens Oversight of Managed Care Organizations: Ensures compliance with state and federal laws, enhancing transparency and public access to audits.

✅ Improves Mental Health & Substance Use Care: Prevents unfair restrictions and mandates adequate provider networks, ensuring access to necessary services.

✅ Protects Providers: Prohibits unfair payment reductions and retroactive denials, promoting financial stability for providers.

✅ Enhances Transparency & Communication: Requires regular updates and public reporting on managed care organization performance.

✅ Redirects Excess Profits to Healthcare Services: Reinvests excess funds into vital programs like early intervention, medical respite, and prenatal care.

Support for AM 728 and AM 814

LB 380 with AM 728 and AM 814 further strengthens provider protections and improves Medicaid recipient care:

🔵 Enhanced Audit Procedures: Requires clear justification for audits and limits claim reviews to three years after payment.

🔵 Clear Communication: Mandates detailed notifications regarding audit findings and providers' appeal rights.

🔵 Fair Claims Adjustment Opportunities: Allows resubmission of claims denied due to unclear documentation or miscoding.

🔵 Collaboration with Healthcare Professionals: Ensures audits are conducted by licensed specialists familiar with the relevant medical field.