State Tracker Updated June 15, 2026

Nebraska: what the PBM reimbursement law requires

Nebraska requires its Medicaid plans to reimburse small independent pharmacies at the fee-for-service level — a NADAC-based rate plus a $10.38 professional dispensing fee — but the floor is Medicaid-only and does not reach commercial plans.

Status	Partially enacted
Law	LB 204 (2024) — Neb. Rev. Stat. § 68-9,111
Effective date	Beginning fiscal year 2024-25
Reimbursement basis	A floor applies to Medicaid only. Nebraska Medicaid (fee-for-service and managed care) must reimburse small independent pharmacies — those owning six or fewer pharmacies — on the state's NADAC-based fee-for-service basis plus a professional dispensing fee, set at $10.38 per prescription until a biennial cost-of-dispensing survey replaces it. There is no commercial floor.
Professional dispensing fee	$10.38 per prescription (interim, pending a cost-of-dispensing survey)

Nebraska’s LB 204 (Neb. Rev. Stat. § 68-9,111) extends a Medicaid reimbursement floor to small independent pharmacies — those owning six or fewer pharmacies — beginning in fiscal year 2024-25. It directs the department to pay a fee-for-service professional dispensing fee of $10.38 per prescription until a cost-of-dispensing survey sets the rate, and to amend Medicaid managed-care contracts so that managed care matches the fee-for-service level.

Because Nebraska Medicaid pays ingredient cost on a NADAC basis, the practical effect is a NADAC-based reimbursement plus the $10.38 fee — but only within Medicaid. The provision does not reach commercial plans, so Nebraska is shown here as partially enacted.

Sources

Neb. Rev. Stat. § 68-9,111 — Nebraska Legislature (codified) Primary source
Nebraska DHHS — Medicaid Pharmacy Services Primary source

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