CLEAR News - Summer 2003

Nebraska Changes Credentialing Fees Structure
By Mary Maahs Becker
Health Program Manager
Nebraska Department of HHS Regulation and Licensure

Legislative bill 242 introduced by Senator Jim Jensen on behalf of the Department of Health and Human Services Regulation and Licensure has been passed by the Nebraska State Legislature and signed by Governor Johanns.  It changes the structure of credentialing fees in Nebraska. The bill is an example of the Nebraska Credentialing Reform (NCR) program efforts to ensure more efficient and productive operations.  Prior to drafting legislation, the NCR program held public meetings across the State to provide information about the credentialing fees proposed.   Based on testimony at the legislature�s public hearing on LB 242, it is clear the Department had broad support from professional boards and associations as well as the senators of Nebraska�s Legislature in part because the department shared the fee structure developmental information and listened to feedback received.  

LB 242 changes the way initial and renewal credentialing fees are calculated and puts into place a formula that has the potential to lower credentialing fees for many professions and occupations.  The formula established fees by considering base costs which are common to all credentialed professions and occupations, as well as variable costs unique to a profession or occupation.  Costs or expenses from the past two fiscal years are used by the formula to establish the base and variable credentialing costs.  Initial and renewal credentialing fees are set to generate revenue adequate to support credentialing activities of the Department and must also include usual and customary cost increases, a reasonable reserve, and the cost of any new or additional credentialing activities.   

Existing provisions of law related to credentialing fees are outright repealed.  They required that the cost of operation and administration of professional boards be paid from fees received by the boards � in other words, each profession or occupation needed to support itself.  For a profession or occupation that does not issue a very large number of credentials, that meant credentialing fees could fluctuate significantly each budget cycle especially if a costly investigation took place.  Some professions paid credentialing renewal fees that were twelve times those paid by other professions.  Projections using the new fee structure show the highest renewal would be less than twice the lowest creating a more fair and equitable system that reduces credentialing costs for most professions and occupations.  The new statutes define base costs that are common to all credentialed professions so it includes all salaries to support credentialing activities and all investigation costs.  By including all salaries in the base, the department has the flexibility to move staff to high need areas during busy times.  By including all investigation costs in the base, the professional boards have a guarantee that a few expensive investigations will not significantly impact anyones credentialing renewal fees.