Medicaid & Access: Gov. Jim Pillen signed LB1091 to change Medicaid payments for rehab centers and nursing facilities treating severe brain and spinal cord injuries, shifting payments away from managed care for fewer than 150 Nebraskans. Medicaid Work Rules: New federal guidance lets states use a “tier system” to exempt people from Medicaid work/volunteer requirements based on medical frailty, but advocates warn it could still create red tape and coverage losses. Obamacare Refunds: The White House says nearly 1 million Americans in 30 states, including Nebraska, will get $500 refunds for alleged Obamacare “user fee” overcharges, with eligibility tied to buying plans on HealthCare.gov without premium subsidies. Public Health Alert: Nebraska extended health alerts for harmful algal blooms at Big Indian Lake and Cub Creek Lake, advising residents to avoid swallowing lake water and to keep pets out. Foodborne Illness: A Cyclospora outbreak linked to recalled lettuce—reported with 12,883 illnesses, 570 hospitalizations, and two deaths across 21 states—has ended, though FDA’s investigation continues. Legal/Health Policy: The Nebraska Supreme Court rejected another challenge to the state’s voter-approved medical cannabis laws, dismissing a long-running federal preemption argument. Community Mental Health: The Palisades Community Renewal Center marked its first year with free therapy and wellness support for wildfire-impacted families.