Legislative Update 3/29: Pediatric hospital priorities, Nebraska budget, Nebraska legislation

US capitol

This is the legislative update for March 29, 2021. View all updates here.



The March 29, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates

The House and Senate are on recess this week and next.

Congress

On March 22, Children’s Hospital Association (CHA) sent a letter to President Biden outlining children’s hospitals’ top policy priorities. The letter thanks the president for the work to date supporting children and families, and highlights additional immediate actions needed for children, including:

  • Prioritizing a strong and stable Medicaid program for children
  • Ensuring a sustainable pediatric healthcare safety net by providing immediate additional relief funding for pediatric providers who are all high Medicaid providers for the nation’s children
  • Prioritizing agency support to address our growing and tragic children’s behavioral health crisis now
  • Supporting critical pediatric workforce training through the Children’s Hospital Graduate Medical Education Program (CHGME)
  • Leading a strong nationally coordinated vaccine plan for children — we have over 40 million children under the age of 12, and have yet to advance vaccines for this large group of kids

It’s necessary to consistently emphasize the different priorities of pediatric hospitals. Last week, we focused on the fact that funding is higher for adult graduate medical education than it is for children’s hospital graduate medical education.

This week, we’re looking at the differences in reimbursement for Medicaid compared to Medicare, given the latest action in the Senate.

Last week, the Senate passed by a 90-2 vote a healthcare provisions bill introduced by Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine). One of the provisions eliminates the 2% across-the-board cut to Medicare payments (known as “sequestration”) until the end of fiscal year 2021. In order to pay for this, the bill increases fiscal year 2030 sequester cuts.

The House is expected to take up the bill when it returns to DC during the week of April 15.

It’s important to explain to lawmakers that while this bill is important for adult healthcare systems, it does not impact pediatric hospitals like Children’s. When provider relief funding (PRF) is coupled with rate increases at the state or federal level, it all becomes part of the larger story.

State Updates

Nebraska Legislature

We anticipate a quiet week in the legislature (famous last words) as they head into a 4-day holiday weekend.

Budget Proposal

Last week, we anticipated that the final state budget proposal would be sent to the floor. However, it was delayed when Chairman of the Appropriations Committee Senator John Stinner (R-Dist. 48, Gering) took a few days to finalize prison funding amendments with the Governor’s office. Speaker of the Legislature Mike Hilgers (R-Dist. 21, Lincoln) announced that the budget debate will likely be scheduled for the week of April 5th.

Advocacy partners Nebraska Association of Behavioral Health Organizations (NABHO) have floated the idea of an additional behavioral health rate increase as an amendment during the budget bills’ floor debate. However, senators were hesitant to go beyond the 2% rate increase that’s already been proposed for all Medicaid providers (including behavioral health providers) each year over the next two years — a proposal that costs $90 million.

Bills Signed into Law

Governor Ricketts signed 15 bills into law and has another 17 on his desk, awaiting his signature.

Two of the bills that are of particular interest to Children’s include:

  1. LB337 (Adopt the Step Therapy Reform Act): The Legislature votes 43-0 to pass the Step Therapy Reform Act, which was introduced by Senator Mark Kolterman (R-Dist. 24, Sewart). The Governor has five days (excluding Sunday) to sign the bill. Once signed into law, the bill will be effective after 90 days.
  2. LR25: This resolution was introduced by the Health and Human Services (HHS) Committee to appoint a Youth Rehabilitation and Treatment Center Special Oversight Committee of the Legislature. Last week, Speaker Hilgers signed the legislative resolution after the one (and only) round of debate — a rule for resolutions as LR’s make a formal expression of opinion, intent or recognition ,or amend the state or federal constitution.

New Amendment

LB390: Provide for credentials based on reciprocity and change requirements for credentials under the Uniform Credentialing Act.

The Legislature advanced Senator Dave Murman’s (R-Dist. 38, Glenvil) bill, LB390. Senator Murman introduced this bill at the request of the Governor to increase access to care by allowing licensed providers to immediately be able to practice in Nebraska. Some of the eligible providers include:

  • Nurses
  • Dentists
  • EMS practitioners
  • Optometrists
  • Podiatrists
  • Pharmacists
  • Psychologists

Last week, the HHS Committee’s amendment AM447 was adopted. The amendment removed physicians from the bill, at the request of the Nebraska Medical Association (NMA). It also requires applicants to establish Nebraska residency within 180 days of being issued their credential in order for reciprocity benefits (Translation: Agreement between states to recognize credentials issued by each other).

The bill is now on Select File.

Legislation We’re Watching

We have put together a comprehensive summary to shed light on the key bills that Children’s is actively lobbying. The summary is color-coded:

Green: Bill is likely to pass
Orange: Bill will require additional effort to advance
Red: Bill is unlikely to advance this year

LB400 (Arch) Change requirements for telehealth (Select File)
  • Parity for behavioral health reimbursement bills underway with LB487 (Select File)
LB89 (Morfeld) Change the age of majority (In Committee)
LB247 (Pansing Brooks) Create the Mental Health Task Force (General File)
LB322 (Williams) Adopt the Safe2Help Hotline statewide (Select File)
LB281 (Albrecht) Require sexual abuse training in schools (Select File)
LB166 (Geist) Josh the Otter- Be Safe Around Water (General File)
LB87 (Morfeld) Provide for mental health first aid training in schools (In Committee)
LB529 (Walz) Change provisions for the distribution of lottery funds used for education, transfer powers and duties, create new acts, a bill that creates a registry of social workers in each school and also adds funds for behavioral health training and de-escalation techniques for teachers and school staff. (Select File)
LR25 (HHS) Provide for appointment by the Executive Board of a special committee of the Legislature to be known as the Youth Rehabilitation and Treatment Center Special Oversight Committee of the Legislature (Speaker Signed, legislative resolutions only have one round of debate).
STATE BUDGET Including a 2% increase in FY 21-22 and 2% increase in FY 22-23

Priority Legislation Preparing for Debate

LB474 (Wishart) Adopt the Medical Cannabis Act
LB139 (Briese) Adopt the COVID-19 Liability Protection Act (Slama priority bill)
LB258 (Vargas) Adopt the Healthy and Safe Families and Workplaces Act
LB273 (Lowe) Change provisions relating to youth rehabilitation and treatment centers
LB375 (Kolterman) Adopt the Pharmacy Benefit Manager Regulation and Transparency Act
LB376 (M. Cavanaugh) Authorize the application for and implementation of services and supports for
developmentally disabled children and their families and provide duties for the Advisory Committee on Developmental Disabilities
LB388 (Friesen) Adopt the Nebraska Broadband Bridge Act
LB411 (Lathrop) Require sharing of information with the designated health information exchange
LB428 (HHS) State that juveniles at youth rehabilitation and treatment centers are to receive an appropriate education equivalent to educational opportunities offered in public schools
LB251 (M. Cavanaugh) Organ Tissue Donation for Minors (General File)
LB108 (McCollister) Change provisions relating to the Supplemental Nutrition Assistance Program (General File)
LB154 (Wayne) Require tracking of student discipline as prescribed (General File)
LB452 (McKinney) Adopt the Financial Literacy Act
LB583 (Murman) Require electronic prescriptions for controlled substances
LB630 (Bostar) Provide for a study of the efficacy of commercial air filters in classrooms
LB639 (Day) Adopt the Seizure Safe Schools Act
LR11CA (Erdman) Constitutional amendment to require enactment of a consumption tax and prohibit certain other forms of taxation

Unlikely to Advance During This Legislative Session

LB30 (Wayne) Limit the amount an insured pays for prescription insulin drugs
LB52 (Lathrop) Provide for immunity for injury or death resulting from COVID-19 exposure
LB53 (Lathrop) Provide immunity for health care providers acting in conformance with the crisis standard of care during a COVID-19 state of emergency
LB67 (Day) Change provisions relating to school-based health centers under the Medical Assistance Act
LB117 (M. Cavanaugh) Adopt the Hunger-Free Schools Act
LB447 (M. Cavanaugh) Change requirements for immunizations in daycare facilities
LB643 (B. Hansen) Protect an individual liberty right to accept or decline a vaccination under a mandatory directive
LB129 (McCollister) Continuous eligibility for minors enrolled in Medicaid
LB115 (McCollister) Impose sales tax on candy and soft drinks and provide for distribution of proceeds
LB392 (Stinner) Adopt the Prescribing Psychologist Practice Act
LB459 (M. Cavanaugh) Change provisions relating to the cigarette tax and the Tobacco Products Tax Act and distribute tax proceeds as prescribed

Child Health Champion Advocacy Team

Please join the Children’s Child Health Champion Advocacy Team every Thursday at 7:30 a.m. for a 30-minute call.

Advocating for children is extremely important at all stages. This internal group of stakeholders — comprised of providers and experts across the continuum of care at Children’s — meets weekly to ensure we are leading the discussion on child advocacy in the region.

Learn more about our advocacy and legislative work in our community.
Advocacy & Outreach

If you are interested in joining the movement, contact Liz Lyons at llyons@childrensomaha.org for more information.

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