Statute 44 1402

44-1402. Terms, defined.For purposes of the Nebraska Right to Shop Act:(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;(2) Department means the Department of Insurance;(3) Director means the Director of Insurance;(4) Enrollee means an individual receiving health insurance coverage from an insurance carrier;(5) Health care entity means:(a) A facility licensed under the Health Care Facility Licensure Act;(b) A health care professional licensed under the Uniform Credentialing Act; and(c) An organization or association of health care professionals licensed under the Uniform Credentialing Act;(6) Incentive payment means a payment described in section 44-1407 that is made by an insurance carrier to an enrollee;(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

lee;(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;(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(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:(a) Physical and occupational therapy services;(b) Obstetrical and gynecological services;(c) Radiology and imaging services;(d) Laboratory services;(e) Infusion therapy;(f) Inpatient or outpatient surgical procedures; and(g) Outpatient nonsurgical diagnostic tests or procedures.Source Laws 2018, LB1119, § 12. Cross References Health Care Facility Licensure Act, see section 71-401.

r outpatient surgical procedures; and(g) Outpatient nonsurgical diagnostic tests or procedures.Source Laws 2018, LB1119, § 12. Cross References Health Care Facility Licensure Act, see section 71-401. Uniform Credentialing Act, see section 38-101.