Nebraska LB 77 (no AI-only prior-auth denials)
Nebraska Legislative Bill 77 (2025) — Ensuring Transparency in Prior Authorization Act (no AI-only health-care denials)
Nebraska · Neb. LB 77 (109th Leg., 2025), operative Jan. 1, 2026
- Status
- In effect
- Took effect
- January 1, 2026
- Applies to
- Health plans, insurers, and utilization review agents operating in Nebraska for fully insured plans.
- Enforced by
- Nebraska Department of Insurance
Nebraska's Ensuring Transparency in Prior Authorization Act bars utilization review agents from using an AI-based algorithm or automated system as the sole basis for denying, delaying, or modifying a health care service based, in whole or in part, on medical necessity. Any prior authorization denial based on medical necessity must involve human clinical review, not AI alone. The law also requires a single standardized prior authorization form of no more than two pages, streamlining the administrative process. Signed June 4, 2025 by Governor Pillen; effective January 1, 2026.
Who is protected: Nebraska health insurance enrollees whose prior authorization requests are subject to utilization review.
Legal detail
LB 77 (109th Neb. Legislature, 2025), enacted June 4, 2025, operative January 1, 2026 for fully insured plans. Amends Nebraska insurance law to: (1) prohibit utilization review agents from using an AI algorithm as the sole basis to deny, delay, or modify health care services on medical necessity grounds; (2) require a standardized prior authorization form of ≤2 pages; (3) establish clear timelines for utilization review decisions. Nebraska joins Arizona, California, Georgia, Indiana, Iowa, Illinois, Washington, and Colorado in restricting AI-only prior authorization and coverage denial decisions.
Key facts
| Jurisdiction | Nebraska |
|---|---|
| Level | State |
| Strength | Moderate |
| Enacted | June 4, 2025 |
| Citation | Neb. LB 77 (109th Leg., 2025), operative Jan. 1, 2026 |
| Penalties | Subject to existing Nebraska insurance code enforcement and penalty provisions. |
| Topics | healthcare AI · insurance AI · automated decision-making |
| Legal analysis | Governor Pillen Signs Significant Prior Authorization Reform into Law — Nebraska Medical Association |
More AI rules in Nebraska
- Nebraska Gov. Pillen EO rescinding ImagiNE Act data center incentives for new applications · In effect
- Nebraska LB 1261 behind-the-meter generation (2026) · In effect
- NE LB 989 (2018 AV) · In effect
- Nebraska NDPA · In effect
- NE Synthetic NCII Civil Remedy · In effect
- Nebraska LB 383 (AI/computer-generated CSAM) · In effect
Related healthcare AI rules elsewhere
- Missouri AI Therapy Chatbot Ban (SB 1019) · In effect
- PA v. Character.AI (Fake Psychiatrist Chatbot) · Blocked / in litigation
- RI Therapy Chatbot Ban (2026) · In effect
- RI AI Companion Self-Harm Safety (2026) · Enacted (not yet in effect)
- California AB 489 (AI healthcare chatbot misrepresentation ban) · In effect
- AZ HB 2175 (AI Insurance Denial — Physician Review) · In effect
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