PREPARED BY: Mikayla Findlay
LB 365 DATE PREPARED: February 21, 2025
PHONE: 402-471-0062
Revision: 00
FISCAL NOTE
LEGISLATIVE FISCAL ANALYST ESTIMATE
ESTIMATE OF FISCAL IMPACT – STATE AGENCIES (See narrative for political subdivision estimates)
FY 2025-26 FY 2026-27
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS $34,138 $70,006
CASH FUNDS
FEDERAL FUNDS $57,512 $113,294
OTHER FUNDS
TOTAL FUNDS $91,650 $183,300
Any Fiscal Notes received from state agencies and political subdivisions are attached f ollowing the Legislative Fiscal Analyst Estimate.
This bill requires coverage for self-measure blood pressure monitors and associated services under the medical assistance program,
Medicaid, no later than January 1, 2026. The Department of Health and Human Services ( DHHS) estimates the costs of including this
service is $183,300 for a full year. This estimate is based on 705 clients taking up the service, $80 for the device, and $15 monthly
service fee. The fiscal impact appears to be reasonable; Blood-pressure monitors would not necessarily need annual replacement
however the devices would need to be purchased for each new clie nt and the devices would degrade over time. DHHS utilizes a fund
mix assumption of 62.75% for FY26 and 61.81 % for FY27 based on a blended Federal Medical Assistance Percentage ( FMAP) that
combines higher federal participation for the Medicaid expansion population and a lower federal participation for regular Medicaid .
ADMINISTRATIVE SERVICES STATE BUDGET DIVISION: REVIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 365 AM: AGENCY/POLT. SUB: Nebraska Department of Health & Human Services
REVIEWED BY: Ann Linneman DATE: 2 -21-2025 PHONE: (402) 471-4180
COMMENTS: Concur with the Nebraska Department of Health and Human Services’ assessment of fiscal impact.
LB (1) 365 FISCAL NOTE 2025
ESTIMATE PROVIDED BY STATE AGENCY OR POLITICAL SUBDIVISION
State Agency or Political Subdivision Name:(2) Department of Health and Human Services
Prepared by: (3) John Meals Date Prepared 2-21-25 Phone: (5) 471-6719
FY 2025-2026 FY 2026-2027
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS $34,138 $70,006
CASH FUNDS
FEDERAL FUNDS
$57,512 $113,294
OTHER FUNDS
TOTAL FUNDS
$91,650 $0 $183,300 $0
Return by date specified or 72 hours prior to public hearing, whichever is earlier.
Explanation of Estimate:
LB365 requires the Department of Health and Human Services (DHHS) to provide coverage and
reimbursement for self-measure blood pressure monitoring services for all persons eligible under Nebraska
Medicaid by January 1, 2026. Covered services include a monitoring device, initial and replacement cuffs
necessary to diagnose or treat hypertension, patient education and training on the set-up and usage of the
device, collection of data, and reporting to a health care provider to create or modify treatment plans.
This fiscal note assumes that services will be added for 705 members per year. At an estimated cost of $80 for
the monitoring device and all needed cuffs, the increase in aid expenditures is $56,400 annually. For the
services involving data collection, interpretation of results, and reporting, this fiscal note assumes a monthly
cost of $15 per member. For these 705 members, the result is an annual increase in aid expenditures of
$126,900. With an implementation date of January 1, 2026, the increase in expenditures for SFY 2026 is
$91,650 Total Funds ($57,512 Federal Funds and $34,138 General Funds). For SFY 2027, the increase is
$183,300 Total Funds ($113,294 Federal Funds and $70, 006 General Funds). Based on the proportion of
regular Medicaid members and expansion newly members, a blended FMAP of 62.75% was used for SFY
2026 and 61.81% for SFY 2027.
Other increases in aid expenditures will be minimal as a result of LB365. Changes to fee schedules would
need to be made. Approval from the Centers for Medicare and Medicaid (CMS) would be needed. The
expenses related to the other increases in aid expenditures, and to the time and effort of changing fee
schedules and receiving app roval from CMS, would be absorbed by DHHS.
MAJOR OBJECTS OF EXPENDITURE
PERSONAL SERVICES:
NUMBER OF POSITIONS 2025-2026 2026-2027
POSITION TITLE 26-26 26-27 EXPENDITURES EXPENDITURES
Benefits...............................................................................................................................
Operating............................................................................................................................
Travel..................................................................................................................................
Capital Outlay.....................................................................................................................
Aid......................................................................................................................................
$91,650 $183,300
Capital Improvements.........................................................................................................
TOTAL............................................................................................................
$91,650 $183,300