Nebraska
LLC
Website link to register:
https://sos.nebraska.gov/business-services
Naming conventions
PLLC names must identify the type of professional service offered. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLC required for medical practices.
Licensing Requirements
Medical licenses must be approved by the Nebraska Department of Health & Human Services. Proof of malpractice insurance required. Comply with Nebraska Department of Health and Human Services’ facility standards.
Required documentation for medical practices
Articles of Organization, Operating Agreement, Facility Standards Compliance, Professional Licenses
Filing Fee: $100
Annual/Biennial Fee: None
Additional Notes: No annual report requirement for LLCs.
Medicaid
Program Name: Nebraska Medicaid
Official Website: https://dhhs.ne.gov/Pages/Medicaid-Eligibility.aspx
Legislation: Nebraska passed LB 817 in 2016, defining DPC agreements as not being insurance and exempting them from state insurance laws.
Private Contracting
Explicitly permitted; DPC agreements are recognized and not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
Nebraska Medicaid, known as Heritage Health, provides health coverage to eligible low-income residents.
Notification Requirements
Notification required if Medicaid patients are not accepted under the program.
Provider Enrollment Requirements
Providers must enroll with Nebraska Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
"Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot serve as Medicaid PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Exemptions may apply for managed care beneficiaries.
Billing Clarity
Cannot bill Medicaid patients for covered services unless clearly agreed upon.
CMS Guidance
CMS encourages states to adopt streamlined enrollment processes for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state healthcare programs.
State-Specific Notes
Collaboration opportunities exist with Nebraska Medicaid Managed Care Organizations for DPC integration.
Dispensing Medication
Board of Pharmacy Official Link: https://dhhs.ne.gov/licensure/Pages/Pharmacist.aspx
State Licensing
Physicians must register with the Nebraska Department of Health and Human Services for controlled substances.
Scope of Practice
Dispensing is allowed within the scope of a physician’s practice; controlled substances require additional registration.
Inventory Management
Accurate inventory logs and secure storage are required for all medications.
Record-Keeping
Records must comply with Nebraska state and federal laws, including HIPAA.
Dispensing Standards
Labels must include patient, prescriber, and medication details as per Nebraska standards.
Controlled Substances
DEA registration and reporting to Nebraska’s PDMP are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must comply with state-specific and federal regulations.
Federal Compliance
Adherence to federal FDA, DEA, and OSHA regulations is mandatory.
State Pharmacy Laws
Physicians must comply with Nebraska pharmacy board rules for controlled substances dispensing.
Patient Consent
Patient consent is required prior to dispensing medications.
Insurance and Liability
Liability insurance must explicitly cover dispensing risks.
Training Requirements
Continuing education for compliance with Nebraska controlled substances laws is encouraged.
Audits and Inspections
Regular inspections by the Nebraska Department of Health ensure compliance, with penalties for violations.