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22-6-91
Section 22-6-91 Definitions. For purposes of this article, the following words shall have the
following meanings: (1) HEALTHCARE SERVICES. Any services of the type for which the Medicaid
Agency may reimburse a provider. (2) PARTNERSHIP HOSPITAL PROGRAM. The Medicaid managed care
program for the provision of inpatient care in this state. (Act 2002-410, p. 1031, §2.)...
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22-6-96
Section 22-6-96 Transfer of funds - Return of uncertified funds. In the event a hospital or
hospital system transfers funds to the Medicaid Agency and fails to certify that the funds
transferred are in compliance with the requirements of Section 22-6-93, the Medicaid Agency
shall return any portion of the funds not certified to the transferor hospital or hospital
system no later than 90 days after the close of the transferor hospital's or hospital system's
fiscal year. (Act 2002-410, p. 1031, §7.)...
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40-26B-22
Section 40-26B-22 Payment and collection of privilege assessment; appropriation of funds and
use by Alabama Medicaid Agency. (a) The privilege assessments imposed by this article shall
be due and payable in monthly installments to the department on or before the twentieth day
of the month next succeeding the month in which the assessment accrues, and shall, when collected,
be paid by the department into the State Treasury. Payment by United States mail will be timely
if mailed in accordance with Section 40-1-45. When so paid into the State Treasury, all such
privilege assessments shall be deposited to the credit of the Alabama Health Care Trust Fund
or any successor fund administered by or on behalf of the Alabama Medicaid Agency. (b) The
receipts from the privilege assessments levied in this article shall be solely available for
appropriation by the Alabama Legislature to the Alabama Medicaid Agency for use by the agency
in accomplishing the purposes of this article. Provided,...
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40-26B-85
Section 40-26B-85 Eligibility and benefit expansions. Except for Medicaid expansion under the
Affordable Care Act, as amended, if the Medicaid Agency elects to liberalize the eligibility
criteria for individuals who apply for Medicaid services or to expand or increase the medical
assistance benefits as defined in Title XIX of the Social Security Act which it currently
provides to Medicaid beneficiaries, the state share of such funds necessary to increase medical
assistance benefits or allow more persons to become eligible for Medicaid shall only be appropriated
from the state General Fund and not from any funds produced or segregated for hospital payments
under this article. (Act 2009-549, p. 1454, §2; Act 2019-278, §1.)...
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22-6-154
Section 22-6-154 Quality assurance committee; collection and publication of information. (a)
The Medicaid Agency shall create a quality assurance committee appointed by the Medicaid Commissioner.
The members of the committee shall serve two-year terms. At least 60 percent of the members
shall be physicians who provide care to Medicaid beneficiaries served by a regional care organization.
In making appointments to the committee, the Medicaid Commissioner shall seek input from the
appropriate professional associations. (b) The committee shall identify objective outcome
and quality measures, including measures of outcome and quality for ambulatory care, inpatient
care, chemical dependency and mental health treatment, oral health care, and all other health
services provided by coordinated care organizations. Quality measures adopted by the committee
shall be consistent with existing state and national quality measures. The Medicaid Commissioner
shall incorporate these measures into...
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40-26B-3
Section 40-26B-3 Payment and collection of tax; appropriation of funds and use by Alabama Medicaid
Agency. (a) The taxes imposed by this article shall be due and payable to the department on
or before the twentieth day of the month next succeeding the month in which the tax accrues,
and shall, when collected, be paid by the department into the State Treasury. Payment by United
States mail will be timely if mailed in accordance with Section 40-1-45. When paid into the
State Treasury, all such taxes shall be deposited to the credit of the Alabama Health Care
Trust Fund. (b) The receipts from the tax levied in this article shall be solely available
for appropriation by the Alabama Legislature to the Alabama Medicaid Agency for use by said
agency in accomplishing the purposes of this article. Provided, however, for the first fiscal
year in which this article is effective, to defray its expenses, including salaries and costs
of operation incident to the collection of this tax, there is...
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43-2-697
Section 43-2-697 Notice to Medicaid Agency of appointment as personal representative or filing
of petition under Section 43-2-692. (a) The personal representative, or person filing to initiate
a proceeding in accordance with the Alabama Small Estates Act, Division 10 of this article,
shall give notice of his or her appointment, or the filing of a petition in accordance with
Section 43-2-692, to the Medicaid Agency. The notice shall include all of the following information:
(1) The full legal name of the deceased. (2) The date of birth of the deceased. (3) The date
of death of the deceased. (4) The Social Security number of the deceased. (5) The marital
status of the deceased at the time of death. (6) The name, address, and phone number of the
spouse of the deceased, if applicable. (7) The court in which a probate estate has been opened.
(8) The probate case number. (9) The date on which letters testamentary or letters of administration
were issued by the probate court. (10) The name,...
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22-6-123
Section 22-6-123 Considerations for inclusions on preferred drug list; review; adoption of
list. (a) Drugs will be considered for the Medicaid preferred drug list based on clinical
efficacy, side effect profiles, appropriate usage, and cost effectiveness. (b) The Medicaid
Pharmacy and Therapeutics Committee shall perform a thorough review of relevant clinical and
medical considerations, including, but not limited to: Medicaid Drug Utilization Review (DUR)
data; Surveillance Utilization Review (SUR) data; potential abuse, misuse, or inappropriate
use in prescribing and/or dispensing patterns; inconsistency with FDA approved labeling, inconsistency
with uses recognized in the American Hospital Formulary Service Drug Information, and the
American Medical Association Drug Evaluations, or the U.S. Pharmacopoeia Dispensing Information.
(c) The Medicaid Pharmacy and Therapeutics Committee shall recommend and the Medicaid Agency
shall adopt an initial Medicaid preferred drug list not later...
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22-6-195
Section 22-6-195 Privilege assessment - Payment; disposition of funds. (a) The assessment imposed
by this article shall be due and payable to the department on or before the twentieth day
of the month next succeeding the month in which the assessment accrues and, when collected,
shall be paid by the department into the State Treasury. Payment by United States mail shall
be timely if mailed in accordance with Section 40-1-45. When paid into the State Treasury,
all such taxes shall be deposited to the credit of the Alabama Health Care Trust Fund or any
successor fund administered by or on behalf of the Medicaid Agency. (b) The receipts from
the assessment levied in this article shall be solely available for appropriation by the Legislature
to the Medicaid Agency for use by the agency in accomplishing the purposes of this article.
(Act 2014-126, p. 236, §6.)...
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22-6-200
Section 22-6-200 Federal financial participation; contract for services. This article shall
be of no effect if federal financial participation under Title XIX of the Social Security
Act is not available to the Medicaid program for the purposes of this article at the approved
federal medical assistance percentage, established under Section 1905 of the Social Security
Act, for the applicable fiscal year, or in the event a contract for services between the PACE
program and the State of Alabama Medicaid Agency or Regional Care Organization is not executed
by September 30, 2014, and by the end of each subsequent state fiscal year thereafter. (Act
2014-126, p. 236, §11.)...
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