22-6-224
Section 22-6-224 Medicaid Agency to contract for medical care; enrollment; delivery of services;
reimbursement. (a) Subject to approval of the federal Centers for Medicare and Medicaid Services,
the Medicaid Agency shall enter into contracts with one or more integrated care networks to
provide, pursuant to a risk contract under which the Medicaid Agency makes a capitated payment,
medical care to Medicaid beneficiaries assigned to the integrated care network. The Medicaid
Agency may enter into a contract pursuant to this section only if, in the judgment of the
Medicaid Agency, care of Medicaid beneficiaries would be better, more efficient, and less
costly than under the then existing care delivery system. Pursuant to the contract, the Medicaid
Agency shall set capitation payments for the integrated care network. (b) The Medicaid Agency
shall enroll beneficiaries it designates into an integrated care network consistent with guidance
from the Center for Medicare and Medicaid Services. (c)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-224.htm - 1K - Match Info - Similar pages

22-6-7
Section 22-6-7 Medicaid Agency authorized to contract with fiscal intermediaries for purpose
of receiving, processing, and paying claims. (a) The Medicaid Agency of the State of Alabama,
the single state agency charged with responsibility for administering the Alabama Medicaid
Program, is hereby authorized to contract, for periods not to exceed seven years, with one
or more fiscal intermediaries for the purpose of receiving, processing, and paying claims
for services rendered recipients of the Alabama Medicaid Program; provided, that such contracts
shall comply in all other respects with the provisions of the Alabama Competitive Bid Law
as codified in Sections 41-16-20 through 41-16-32, as amended. (b) The provisions of subsection
(a) notwithstanding, the Medicaid Agency of the State of Alabama may extend the present contract
in existence on September 1, 2007, for two additional years through September 30, 2011. (Acts
1978, 2nd Ex. Sess., No. 93, p. 1793; Acts 1987, No. 87-279, p. 388;...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-7.htm - 1K - Match Info - Similar pages

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,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/43-2-697.htm - 5K - Match Info - Similar pages

27-21B-3
Section 27-21B-3 Power to conduct investigations. The Alabama Medicaid Agency is authorized
and empowered to conduct investigations to determine whether a medical support order exists
or eligibility for enrollment of a recipient in a parent's family health coverage exists.
The parents of any child who is a recipient shall cooperate in this investigation. State agencies
may share information regarding parentage and support orders. (Acts 1994, No. 94-710, p. 1377,
§3.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21B-3.htm - 779 bytes - Match Info - Similar pages

40-26B-25
Section 40-26B-25 Use of revenues; reimbursement. (a) The Alabama Medicaid Agency shall use
the revenues from the privilege assessment in furtherance of the purposes of this article,
provided that any uses shall be limited to those for which federal financial participation
under Title XIX of the Social Security Act is available. (b) Any reimbursement due a nursing
facility under the Medicaid program shall be paid in a timely fashion. If the amount payable
is not in dispute and is not paid by the Alabama Medicaid Agency within 30 days of the due
date, interest on the amount due shall be charged. The interest rate shall be the legal amount
currently charged by the state. Acts 1991, No. 91-126, p. 153, §5; Acts 1992, No. 92-440,
p. 871, §1; Act 97-901, 1st Ex. Sess., p. 277, §1; Act 2011-614, p. 1376, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-25.htm - 1K - Match Info - Similar pages

40-26B-6
Section 40-26B-6 Use of revenues; reimbursement. (a) The Alabama Medicaid Agency shall use
the revenues from the tax levied by this article in furtherance of the purposes of this article,
provided that any such uses shall be limited to those for which federal financial participation
under Title XIX of the Social Security Act is available. (b) Any reimbursement due a pharmaceutical
provider under the Medicaid Program shall be paid in a timely fashion. If the amount payable
is not in dispute and is not paid by the Alabama Medicaid Agency within 30 days of the due
date, interest on the amount due shall be charged. The interest shall be the legal amount
currently charged by the state. (Acts 1991, No. 91-124, p. 148, §5.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-6.htm - 1K - Match Info - Similar pages

22-6-164
Section 22-6-164 Rulemaking authority. The Medicaid Agency may adopt rules necessary to implement
this article and to administer the Alabama Medicaid Program in a manner consistent with state
and federal law, as well as any state plan approved by the Centers for Medicare and Medicaid
Services. (Act 2013-261, p. 686, §15; Act 2014-434, p. 1598, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-164.htm - 662 bytes - Match Info - Similar pages

22-6-40
Section 22-6-40 Medicaid Agency authorized to increase financing and adjust insurance premiums
for family practitioners, pediatricians and obstetricians. The Legislature recognizes the
shortage of and the decline in obstetrical care in the rural areas of the state and the hardship
imposed on those who are required to travel many miles to obtain the necessary prenatal care
and ultimately delivery at term. The Legislature further recognizes the high infant mortality
rates that are attributed in part to inadequate care during pregnancy, delivery, and necessary
care after delivery. The Legislature further recognizes that the reduction in available care
and services is attributed in part to high liability insurance premiums. In recognizing the
ability of the Alabama Medicaid Agency to maximize state revenues, it is the intent of the
Legislature that the Alabama Medicaid Agency provide increased financing for family practitioners,
pediatricians and obstetricians to increase availability of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-40.htm - 1K - Match Info - Similar pages

40-26B-87
Section 40-26B-87 Exclusion from State General Fund. The Commissioner of the Alabama Medicaid
Agency is hereby directed to specifically exclude from the Plan Amendment submitted to the
Centers for Medicare and Medicaid Services regarding the Hospital Assessment Program any language
or calculations that would incur liability to the State General Fund. (Act 2009-549, p. 1454,
§3.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-87.htm - 689 bytes - Match Info - Similar pages

36-35-3
Section 36-35-3 Alabama Prescription Cost Initiative Board. (a) The Alabama Prescription Cost
Initiative Board is created. (b) The board shall consist of the following voting members:
The executive director or chief staff person of the State Employees Insurance Board (SEIB)
and the Public Education Employees Health Insurance Plan (PEEHIP), the Chair of the Board
of Directors of SEIB, the Chair of the Board of Directors of PEEHIP, and the State Health
Officer. The Director of the Medicaid Agency may serve in a nonvoting capacity. (c) The board
shall promulgate policies to implement this chapter and may hire an executive director and
necessary staff to implement and administer this chapter with or without regard to the state
Merit System. (d) The board through its executive director may enter into agreements with
a prescription drug buying group or manufacturer to negotiate price discounts or rebates on
behalf of the board or any participating department or governmental entity. (e) The...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-35-3.htm - 2K - Match Info - Similar pages