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Enhanced Primary Care Payments
Enhanced Primary Care Program Discontinuation Effective July 1, 2026, the Nebraska Medicaid Enhanced Primary Care (EPC) program will be discontinued. Nebraska Medicaid will no longer accept new EPC provider applications as of June 30, 2026. All EPC existing providers will automatically be disenrolled from the program on June 30, 2026, and the EPC fee schedule will end. No action is required from participating EPC providers. For questions, please email [email protected] On December 31, 2014, the enhanced federal funding to certain eligible physicians for the enhanced primary care payment for Medicaid services ended. However, Nebraska Medicaid has chosen to continue primary care enhanced payment to attested providers in the calendar year 2015 and beyond. The enhanced rate is available for providers who are fee-for-service providers with Nebraska Medicaid, as well as eligible providers who are enrolled in the Nebraska physical health managed care program. The increased payments pertain to primary care services delivered by a physician (MD or DO) with a specialty designation of family medicine, general internal medicine, or pediatrics. Physician Assistants who are supervised by a physician that is eligible for the enhanced rate are also eligible to receive the enhanced rate. The increase applies to a specific set of services and procedures that Centers for Medicare & Medicaid Services (CMS) designates as “primary care services." Attestation: In order to qualify for the enhanced rates, eligible enrolled Nebraska Medicaid providers must attest to being a primary care physician by one of the following: Board certification as a primary care physician by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) or Have furnished evaluation & management (E&M) and vaccines services (codes specified by federal regulation) that equal at least 60% of the Medicaid codes billed during the most recently completed fiscal year. Eligible providers who may qualify for the enhanced rate must complete an Attestation Form to be submitted with the identified documentation to the Medicaid central office. Providers must attest for each new provider number or any time the provider's status of eligibility changes. Attestation Form Providers should send forms and documentation to the following address: DHHS Medicaid and Long-Term Care Enhanced PCP Rates P.O. Box 95026 Lincoln, NE 68509-5026 Or Fax to: (402) 471-9103 Attention: Enhanced PCP Rates To assist in delivery of information, a dedicated email address has been created for questions and answers specific to this program change. We will gather the questions and responses and place them on our website. The email address is: [email protected]. Questions Questions regarding enhanced primary care payments may be sent to: [email protected]. Providers Fee Schedule Enhanced Primary Care Provider Fee schedule Board Certification Lists American Board of Medical Specialties (ABMS)American Board of Physician Specialties (ABPS)American Osteopathic Association (AOA) Medicaid Managed Care Contractors for Heritage Health CMS Final Rule: http://www.gpo.gov/fdsys/pkg/FR-2012-11-06/pdf/2012-26507.pdf. Correction to Final Rule: http://www.gpo.gov/fdsys/pkg/FR-2012-12-14/pdf/2012-29640.pdf. Q and A on Increased Medicaid Payments for PCPs Q and A on Set II Increased Payments for PCPs Q and A on Increased Medicaid Payments for managed care
National Correct Coding Initiative
The Centers for Medicare and Medicaid Services (CMS) expects state Medicaid programs to follow the rules of the National Correct Coding Initiative (NCCI). CMS created the NCCI in 1996. NCCI promotes correct coding practices nationwide and controls incorrect coding, which can lead to incorrect payments for Medicaid claims. Coding policies are made based on rules found within the following tools: American Medical Association's Current Procedural Terminology (CPT) manual National and local policies Recent changes to national and local policies Coding guidelines from national societies Analysis of standard medical and surgical practices Reviews of current coding rules. CMS reviews and updates these policies yearly to ensure all NCCI coding practices match Medicaid claims. The CMS website contains the following: Medicaid-specific NCCI manuals More information about NCCI NCCI Policies Coding Policy Manuals NCCI (procedure to procedure and MUE) edits Compliance checks take place to evaluate claims against the NCCI edits both before and after payment. Reviewing pre-payment editing may result in claim denial; reviewing post-payment editing may result in a refund request. CMS instructs states to use NCCI edits first. Edits from each state are then applied to the claims. Payment of a claim is dependent on compliance with all NCCI and Nebraska-specific edits. Most Nebraska Medicaid claims are compatible with CMS standards. Nebraska Medicaid will post changes and helpful tools as they become available. Program Integrity Department of Health & Human Services Division of Medicaid and Long-Term Care Email Address [email protected] Nebraska Implementation of the National Correct Coding InitiativeFrequently Asked Questions (updated 11/20/2017) NCCI Provider Information Betsie Steenson Department of Health & Human Services Division of Medicaid and Long-Term Care Phone Number (402) 471-9353 Email Address [email protected]
Attorney General Mike Hilgers Urges Consumers to Claim Compensation for Inflated Generic Drug Prices
Lincoln – Attorney General Hilger is urging consumers to check their eligibility for compensation for certain generic drug purchases and to submit a claim for compensation here. This month, the U.S. District Court for the District of Connecticut granted preliminary approval of a plan, filed by Nebraska and a coalition of 47 other states and territories, to distribute settlement funds paid by generic drug manufacturers in exchange for settlement of claims that those companies illegally conspired to raise the prices of generic drugs. The coalition previously announced settlements with the manufacturers Glenmark, Lannett, Bausch, Apotex, Heritage, and Heritage’s parent company, Emcure, totaling approximately $96.5 million. The multistate coalition’s distribution plan aims to return millions of dollars from those settlement funds to those potentially harmed by the elevated prices of the generic drugs that are the subjects of those settlements. If you purchased a generic drug listed here between May 2009 and December 2019, you may be eligible for compensation. To determine your eligibility, call 1-866-290-0182 (Toll-Free), email [email protected] or visit www.AGGenericDrugs.com. Nebraska and nearly all other states and territories engaged in a series of antitrust cases against major generic drug manufacturers, beginning in 2016. These cases involve dozens of companies and individuals accused of price-fixing and fraudulent conduct related to generic drugs. Seven pharmaceutical executives are cooperating with the States. The above-mentioned cases stem from a series of investigations built on evidence from several cooperating witnesses at the core of the different conspiracies, millions of documents, and a massive phone record data base. Each complaint addresses a different set of drugs and defendants and lays out an interconnected web of competing industry executives who regularly met and communicated with each other, providing ample opportunity to form illegal agreements. The complaints note that defendants used terms like "fair share," "playing nice in the sandbox," and "responsible competitor" to unlawfully discourage competition, raise prices, and enforce an ingrained culture of collusion. Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Northern Mariana Islands, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming joined in today’s announcement.
Attorney General Hilgers Joins $694 Million Multistate Settlement with Subprime Auto Lender Credit Acceptance Corporation
Attorney General Hilgers Joins $694 Million Multistate Settlement with Subprime Auto Lender Credit Acceptance Corporation Lincoln – Attorney General Mike Hilgers announced that Nebraska, along with the attorneys general for 40 other states, has entered into a settlement with Credit Acceptance Corporation (CAC) providing $694 million in cash and debt relief to consumers in connection with their car loans. Nebraska will receive $124,236.18 from the settlement. CAC is one of the nation’s largest auto finance companies, providing car loans to consumers with limited or impaired credit histories. The settlement also includes injunctive terms that, among other things, require CAC to provide consumers disclosures about loan risks, give consumers protections from bad outcomes from certain risky CAC loans, and help guard consumers from dealers “packing” CAC auto-loan contracts with unwanted Vehicle Service Contracts (VSC) and Guaranteed Asset Protection (GAP) products. The multistate investigation resolves allegations that CAC originated loans that the company knew or should have known consumers could not afford. CAC gives a proprietary “score” to each of its loans representing its prediction of the percentage amount CAC will collect on the loan from all sources. The attorneys general allege that consumers could not reasonably afford many of CAC’s low “score” loans, including those where CAC predicted the consumer would not pay back even the loan’s principal loan amount. Unsurprisingly, many of those low “score” loans resulted in consumers defaulting on their loans and losing their cars when they were repossessed and sold at auction. The settlement provides $60 million in cash restitution that will be distributed to consumers to whom CAC gave particularly risky loans. For certain risky CAC loans made between November 1, 2015, and November 30, 2025, CAC is also required to provide, on or before November 2, 2026, $388,000,000 in debt relief to consumers whose cars have been repossessed, and $246,000,000 in debt relief to consumers whose cars have not been repossessed, allowing those consumers to keep their cars. CAC must also pay an additional $15 million to the attorneys general. The settlement’s injunctive terms include the following long- and short-term requirements designed to meaningfully reform the company’s lending practices: For consumers with certain risky CAC loans that CAC made starting in December 2025, CAC will provide “off ramps” for loans that fail quickly. Qualifying consumers will get 95% debt relief, and CAC is prohibited from filing collections lawsuits against them. CAC must provide these off ramps for a five-year period starting on November 2, 2026. The settlement mandates a process to prevent unlawful VSC and GAP product packing, including enhanced pre-purchase disclosures, a post-purchase process alerting consumers about the purchase(s) and allowing easier product cancelation, and dealer monitoring. CAC must provide consumers with pre-loan disclosures about the risks of default and the value of the vehicle. For seven years, CAC must institute a price cap for vehicle prices at 109% of retail book value for certain consumers. CAC must implement processes to prevent dealers from raising car prices due to credit worthiness or above advertised prices. The Executive Committee leading the settlement comprises the attorneys general of Maryland, Arkansas, California, Illinois, Minnesota, and New Jersey. Joining the settlement are the attorneys general of Alabama, Alaska, Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaiʻi, Indiana, Kentucky, Louisiana, Maine, Michigan, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, and Wisconsin. New York is concurrently settling litigation it brought against CAC in the Southern District of New York. Download News Release
Nebraska Human Trafficking Task Force Summit Draws Over 250 Attendees, Marks Major Collaboration in Statewide Fight
LINCOLN--More than 250 participants from across Nebraska convened at the UNL Innovation Campus on Tuesday, September 15, 2026, for the third annual Nebraska Human Trafficking Task Force Summit, hosted by Attorney General Mike Hilgers. The event brought together law enforcement, prosecutors, service providers, advocates, and community members, highlighting Nebraska’s strong, unified commitment to eradicating human trafficking. The day-long event began with a State-of-the-State discussion, featuring SAC Gene Kowel of the Omaha FBI Field Office and SAC Rick Sabatini of the Kansas City Homeland Security Field Office, who joined AG Hilgers to highlight the FBI and HSI's successful operations to end trafficking in the state and state and federal collaboration. The Summit's keynote speaker was the Honorable Judge Lung, who spoke on Trafficking, Trauma, Resiliency & Evidence-based Hope. The Summit featured expert panels, a case study, and spotlighted the multidisciplinary work of the child advocacy centers in Nebraska. Attorney General Hilgers addressed attendees during the opening and closing remarks, emphasizing the state’s momentum. “Human trafficking is a horrific crime that threatens the safety and dignity of Nebraskans,” Hilgers said. “Together, we are committed to combating this scourge. We will continue to build on our progress, support survivors, and work relentlessly to end human trafficking in our State.” The record turnout and robust agenda highlighted a growing statewide coalition determined to end human trafficking and support survivors. The Nebraska Human Trafficking Task Force continues to lead, fostering collaboration and providing critical support to those on the front lines. For more information about the Nebraska Human Trafficking Task Force and upcoming initiatives, please visit AGO.Nebraska.gov.
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