PREPARED BY: Mikayla Findlay
LB 41 DATE PREPARED: February 24, 2025
PHONE: 402-471-0062
Revision: 01
Revised to reflect provisions included in AM 62 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 $78,575 $80,515
CASH FUNDS
FEDERAL FUNDS $105, 025 $103,085
OTHER FUNDS
TOTAL FUNDS $183,600 $183,600
Any Fiscal Notes received from state agencies and political subdivisions are attached following the Legislative Fiscal Analyst Estimate.
This bill would require an additional two pregnancy-related screenings for syphilis, during the third trimester and at birth, in addition to
the existing screening requirement during the first gestational examination. AM 62 adds provisions that specify that provider s shall
inform recipients that such testing is voluntary may be declined verbally or in writing. The implementation date would be three months
following adjournment and for the purposes of this fiscal note is assumed to be July 1, 2025.
These additional screening requirements would affect Medicaid coverage for pregnancies. The agency fiscal impact is based on an
estimate of cost per test of $12. The Department of Health and Human Services (DHHS) notes that in FY24 there were 8,912 births
under the Medicaid program. Currently, individuals who are deter mined to be high risk already qualify for additional syphilis testing.
Data on how many pregnant Medicaid clients in Nebraska are currently receiving additional testing is not available . The agency
estimated cost of $216,000 is based on $24 for two tests for 9,000 individuals. This fiscal note assumes a total of 1 5% of current
Medicaid pregnancies already qualify for additional testing due to risk. As such, the assumed population is 7,650 and at $24 for two
additional tests the cost is $186,600. The fund mix based on a proportional blend of CHIP, regular Medicaid, and Medicaid expansion
federal participation. The state share is higher in FY27 due to expected reduction in Federal Medical Assistance Percentage (FMAP).
ADMINISTRATIVE SERVICES STATE BUDGET DIVISION: RE VIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 41 AM: 62 AGENCY/POLT. SUB: Nebraska Dept of Health & Human Services
REVIEWED BY: Ann Linneman DATE: 2 -24-2025 PHONE: (402) 471-4180
COMMENTS: Concur with the Nebraska Department of Health & Human Services assessment of fiscal impact.
LB (1) 41 AM62 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 $92,441 $94,724
CASH FUNDS
FEDERAL FUNDS $123,559 $121,276
OTHER FUNDS
TOTAL FUNDS $216,000 $0 $216,000 $0
Return by date specified or 72 hours prior to public hearing, whichever is earlier.
Explanation of Estimate:
LB41 AM62 adds language requiring a blood sample be taken from a pregnant woman at the third trimester
examination and at birth to be submitted for serological testing for syphilis . Currently, this testing is required at
the time of the first examination. This bill includes language that allows each pregnant woman to opt out of the
blood testing.
In SFY24, there were 8,912 Medicaid covered births. It is estimated that LB41 will result in an increase of
18,000 tests annually as a result of three tests being required instead of one. This fiscal note uses an
estimated average rapid plasma regain test of $12. With an implementation date of July 1, 2025, this will result
in an increase in aid expenditures of $216,000 ($123,559 Federal Funds and $92,441 General Funds) in
SFY26. In SFY27, the increase in aid expenditures will be $216,000 ($121,276 Federal Funds and $94,724
General Funds). The blended FMAP for SFY26 used is 57.20% and for SFY27 is 56.15%. The blended FMAP
was based on the proportion of regular Medicaid usage and Children’s Health Insurance Program (CHIP)
usage.
This fiscal note assumes that all Medicaid covered births are currently only receiving one test and so the cost
of two additional tests is included. The department recognizes that some women may already be receiving
additional tests, but the number of additional tests is indeterminable.
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......................................................................................................................................
$216,000 $216,000
Capital Improvements.........................................................................................................
TOTAL............................................................................................................
$216,000 $216,000