{"data":{"id":"us-ne/neb.-rev.-stat.-44-1402","jurisdiction":"us-ne","citation":"Neb. Rev. Stat. § 44-1402","heading":"Neb. Rev. Stat. § 44-1402","body":"For purposes of the Nebraska Right to Shop Act:\n\n(1) Allowed amount means the contractually agreed-upon amount paid by an insurance carrier to a health care entity participating in the insurance carrier’s network or the amount the health plan is required to pay under the health plan policy or certificate of insurance for out-of-network covered benefits provided to the patient;\n\n(2) Department means the Department of Insurance;\n\n(3) Director means the Director of Insurance;\n\n(4) Enrollee means an individual receiving health insurance coverage from an insurance carrier;\n\n(5) Health care entity means:\n\n(a) A facility licensed under the Health Care Facility Licensure Act;\n\n(b) A health care professional licensed under the Uniform Credentialing Act; and\n\n(c) An organization or association of health care professionals licensed under the Uniform Credentialing Act;\n\n(6) Incentive payment means a payment described in section 44-1407 that is made by an insurance carrier to an enrollee;\n\n(7) Insurance carrier means any entity that provides health insurance in this state. Insurance carrier includes (a) an insurance company, (b) a fraternal benefit society, (c) a health maintenance organization, and (d) any other entity providing a plan of health insurance or health benefits subject to state insurance regulation;\n\n(8) Shared savings incentive payment program means a program established by an insurance carrier pursuant to section 44-1407 to provide incentive payments to enrollees; and\n\n(9) Shoppable health care service means a health care service for which an insurance carrier offers incentive payments under a shared savings incentive payment program established by the insurance carrier. Shoppable health care service includes, at a minimum, health care services in the following categories:\n\n(a) Physical and occupational therapy services;\n\n(b) Obstetrical and gynecological services;\n\n(c) Radiology and imaging services;\n\n(d) Laboratory services;\n\n(e) Infusion therapy;\n\n(f) Inpatient or outpatient surgical procedures; and\n\n(g) Outpatient nonsurgical diagnostic tests or procedures.","path":["NE Code","Chapter 44"],"source_url":"https://nebraskalegislature.gov/laws/statutes.php?statute=44-1402","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:21Z","sha256":"5ba1cd6c7aba4710d56a4ee6411880ff29db278953e0d3606882ed5290500345","source_id":"us-ne","stale":false,"prev":"us-ne/neb.-rev.-stat.-44-1401","next":"us-ne/neb.-rev.-stat.-44-1403"},"notice":"GroundRules: Original legal text. Not legal advice."}