Nebraska Certificate of Need Laws
Nebraska
Moderate
Year Enacted
—
Services Regulated
—
National Rank
23 of 51
Top Systems
- No review for imaging
- Beatrice Manor
Dominant Insurer
UnitedHealth (24%)
Reform Status
Heavily Reformed, But Not Repealed
Key Case
No major case law on record.
Nebraska has significantly narrowed its CON program, but the remaining regulations for long-term care beds continue to shield incumbents and limit competition in a critical sector.
6 Services Held Hostage
- ✓Hospitals
- ✓Ambulatory Surgery Centers (ASCs)
- ✓Nursing Homes / Long-Term Care
- ✓Imaging (MRI, CT, PET)
- ✓Rehabilitation Facilities
- ✓Major Medical Equipment
The Permission Process
No review for imaging, ASCs, or general hospital services
The process is managed by the DHHS with no competitor intervention rights.
The Nebraska Healthcare Cartel
Insurer Dominance
- Top Insurer
- UnitedHealth (24%)
- Insurer Landscape
- The insurance market is similarly concentrated, with three carriers controlling over 62% of the market.
- UnitedHealth Group
- BCBS of Nebraska
- Explore our comprehensive overview of Certificate of Need laws across the United States.
Major metropolitan areas are highly concentrated, dominated by a few large systems.
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Blocked, Denied, Upheld
A classic example of central planning failure. Beatrice Manor was denied a CON for additional nursing home beds in Gage County. The state's rationale was not a lack of quality or financial viability, but simply that the county already had 82 beds per 1,000 elderly residents, exceeding the state's arbitrary optimum of 68.6. This denial protected existing facilities from competition at the direct expense of patient choice and potential access to newer facilities.
Heavily Reformed, But Not Repealed
Nebraska's CON law is narrow, primarily acting as a moratorium on new beds in specific long-term care facilities.
Heavily Reformed, But Not Repealed
Data sourced from state statutes, Department of Health and Human Services public records, and independent analysis by The Rojas Report.
Last updated: April 2026