HB112 By Representative McClammy RFD Ways and Means General Fund Rd 1 03-MAR-15

SYNOPSIS: Under existing law, the Alabama Department of Corrections, a county, or a municipality may not seek reimbursement from the Medicaid program for expenses related to the medical costs incurred for an adult who is incarcerated in a correctional facility, county jail, or municipal jail.

This bill would allow the Alabama Department of Corrections, a county, or a municipality to seek reimbursement from the Medicaid program for expenses related to the medical costs incurred for an adult who is incarcerated in a correctional facility, county jail, or municipal jail.

This bill would provide the procedure for applying for reimbursement of the costs.

A BILL TO BE ENTITLED AN ACT

Relating to Medicaid and inmates; to allow the Alabama Department of Corrections, a county, or a municipality to seek reimbursement from the Medicaid program for expenses related to the medical costs incurred for an adult who is incarcerated in a correctional facility, county jail, or municipal jail and to provide the procedure for applying for reimbursement of the costs.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:

Section 2. (a) Notwithstanding any other provision of law, the department, in conjunction with each county, municipality, and the agency, shall develop a process to maximize federal financial participation for the provision of acute inpatient hospital services rendered to individuals who, but for their institutional status as inmates, are otherwise eligible for Medicaid.

(b) Federal reimbursement for acute inpatient hospital services for inmates enrolled in Medicaid shall occur through the agency.

(c)(1) The commissioner of the department, in conjunction with the agency, shall develop a process to claim federal financial participation and to reimburse the department, county, or municipality for the federal share of the allowable Medicaid cost provision of acute inpatient hospital services rendered to inmates according to this section and for any administrative costs incurred in support of those services that shall be applicable to inmates incarcerated in county or municipal jails.

(2) Each hospital that renders service to an inmate shall invoice the department, county, or municipality to obtain reimbursement for acute inpatient hospital services in accordance with contracted rates of reimbursement or regular rate of reimbursement. The department, county, or municipality shall reimburse the hospital for the delivery of acute inpatient hospital services rendered to an inmate pursuant to this section. For individuals eligible for Medicaid pursuant to this section, the department, county, or municipality shall submit a quarterly invoice to the agency for claiming federal participation at the Medicaid rate for acute inpatient hospital services. The agency shall remit funds received for federal participation to the department, county, or municipality for allowable costs incurred as a result of delivering acute inpatient hospital services allowable under this section.

(3) The department, county, or municipality shall reimburse the agency counties for administrative costs that are not reimbursed by the federal government.

(4) The department, county, or municipality shall reimburse the agency for any disallowance that is required to be returned to the agency for any litigation costs incurred due to the implementation of this section.

(d)(1) The department, in consultation with each county and municipality in conjunction with the agency, shall develop a process to facilitate eligibility determinations for individuals who may be eligible for Medicaid.

(2) The department, county, and municipality, as the case may be, shall assist inmates in completing either the Medicaid application as appropriate and shall forward that application to the agency for processing.

(3) Notwithstanding any other state law, and only to the extent that federal law allows and federal financial participation is available, for the limited purpose of implementing this section, the department, a county, or municipality or their designee may act on behalf of an inmate for purposes of applying for or determination of Medicaid.

(e) Reimbursement pursuant to this section shall be limited to those acute inpatient hospital services for which federal financial participation pursuant to Title XIX of the federal Social Security Act is allowed.

(f) This section shall have no force or effect if there is a final judicial determination made by any state or federal court that is not appealed, or by a court of appellate jurisdiction that is not further appealed, in any action by any party, or a final determination by the administrator of the federal Centers for Medicare and Medicaid Services, that limits or affects the authority of the department, county, or municipality to select the hospitals used to provide inpatient hospital services to inmates.

(g) This section shall be implemented in a manner that is consistent with federal Medicaid law and regulations. The agency shall seek any federal approvals necessary for the implementation of this section. This section shall be implemented only when and to the extent that any necessary federal approval is obtained, and only to the extent that existing levels of federal financial participation are not otherwise jeopardized.

(h) To the extent that the agency determines that existing levels of federal financial participation are jeopardized, this section shall no longer be implemented.

Section 3. This act shall become effective on the first day of the third month following its passage and approval by the Governor, or its otherwise becoming law.

Medicaid

Corrections Department

Prisons and Prisoners

Jails