Nebraska Standardized Prior Authorization Forms for Healthcare

NE Insurance News

Published January 1st, 2026

Detected March 20th, 2026

Summary

The Nebraska Department of Insurance is releasing two new standardized prior authorization forms for healthcare services, drug benefits, and durable medical equipment, effective January 1, 2026. These forms, mandated by LB 77, aim to reduce administrative burden and improve efficiency for providers and patients under fully insured plans.

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What changed

The Nebraska Department of Insurance (NDOI) has issued new, standardized prior authorization forms for healthcare services, drug benefits, and durable medical equipment, which will become effective on January 1, 2026. These forms are a result of LB 77 and are intended to replace the current individual forms used by insurance companies. The new standardized forms will apply to all fully insured health plans in Nebraska, aiming to reduce administrative burdens, minimize confusion, and improve efficiency for healthcare providers and patients by ensuring consistent timelines and uniform transparency and response requirements. The legislation also prohibits denials based solely on artificial intelligence.

Healthcare providers and insurers operating in Nebraska must transition to using these new forms by January 1, 2026. While the forms are designed to streamline processes, entities should ensure they understand the specific requirements and confirm plan types, as self-insured and ERISA plans are exempt. The NDOI encourages preparation for this transition and has made the forms and guidance available on their website. Failure to comply with the new standardized forms for fully insured plans could lead to administrative inefficiencies and potential issues with regulatory compliance.

What to do next

Review and adopt the new standardized prior authorization forms for healthcare services, drug benefits, and durable medical equipment.
Ensure all relevant staff are trained on the new forms and procedures.
Confirm plan types to distinguish between fully insured plans (affected) and self-insured/ERISA plans (unaffected).

Source document (simplified)

Lincoln, Neb. (Nov. 18, 2025) – Following the passage of LB 77 during the 2025 Legislative Session, the Nebraska Department of Insurance (NDOI) is announcing the release of two new standardized prior authorization forms for Healthcare Services, Drug Benefits, and Durable Medical Equipment.

The forms were developed after a public comment period from the healthcare and insurance industries. These forms will go into effect January 1, 2026 for all fully insured plans in Nebraska.

LB 77 requires health plan criteria be easily accessible, sets clear review timelines, and prohibits denials based solely on artificial intelligence. Currently, insurance companies have individual forms for prior authorization. The new forms may reduce the administrative burden, minimize confusion, and improve efficiency for providers and patients.

Patients may see more consistent timelines and insurers will have uniform transparency and response requirements.

"These standardized forms are a significant step forward in communication and consistency in healthcare coverage," said Eric Dunning, NDOI Director. "We're helping make sure Nebraskans get the care they need while lessening the administrative burden."

The new forms only apply to fully insured health plans. Self-insured and ERISA plans are not affected by this change. Providers can confirm plan types through insurance company portals, contacting the company directly, or through automated verification systems.

NDOI encourages healthcare providers and insurers to prepare for the transition before January 1, 2026. The forms and guidance are available on the Department's website at doi.nebraska.gov/guidance-documents under the Health section of the guidance documents page.