Nebraska

Liver damage restrictions

Fee-For Service requires moderate liver damage (F2 or greater). Two Managed Care Organizations (MCOs), Nebraska Total Care and WellCare of Nebraska, also require moderate liver damage (F2 or greater). One MCO, UnitedHealthcare Community Plan, requires severe liver damage (F3 or greater).

Sobriety restrictions

FFS and all MCOs require six months of abstinence or evidence of participation in a treatment program.

Prescriber restrictions

FFS does not impose prescriber restrictions. Two MCOs, Nebraska Total Care WellCare of Nebraska also do not impose prescriber restrictions. One MCO, UnitedHealthcare Community Plan, requires a specialist to prescribe.

Recommendations

• Remove liver damage and sobriety restrictions.
• Ensure coverage parity across FFS and MCO programs.