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40-26B-73
Section 40-26B-73 Hospital Assessment Account. (a)(1) There is created within the Health
Care Trust Fund referenced in Article 3 of Chapter 6 of Title 22 of a designated account known
as the Hospital Assessment Account. (2) The hospital assessments imposed under this article
shall be deposited into the Hospital Assessment Account. (3) If the Medicaid Agency begins
making payments under Article 9 of Chapter 6 of Title 22, while Act 2017-382 is in force,
the hospital intergovernmental transfers imposed under this article shall be deposited into
the Hospital Assessment Account. (b) Moneys in the Hospital Assessment Account shall consist
of: (1) All moneys collected or received by the department from privately operated hospital
assessments imposed under this article; (2) Any interest or penalties levied in conjunction
with the administration of this article; and (3) Any appropriations, transfers, donations,
gifts, or moneys from other sources, as applicable; and (4) If the Medicaid Agency...
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40-26B-82
Section 40-26B-82 Effectiveness and cessation. (a) The assessment imposed under this
article shall not take effect or shall cease to be imposed and any moneys remaining in the
Hospital Assessment Account in the Alabama Medicaid Program Trust Fund shall be refunded to
hospitals in proportion to the amounts paid by them if any of the following occur: (1) Expenditures
for hospital inpatient and outpatient services paid for by the Alabama Medicaid Program for
fiscal years 2020, 2021, and 2022, are less than the amount paid during fiscal year 2017.
Reimbursement rates under this article for fiscal years 2020, 2021, and 2022, are less than
the rates approved by CMS in Sections 40-26B-79 and 40-26B-80. (2) The Medicaid Agency makes
changes in its rules that reduce hospital inpatient payment rates, outpatient payment rates,
or adjustment payments, including any cost settlement protocol, that were in effect on September
30, 2019. (3) The inpatient or outpatient hospital access payments required...
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40-26B-71
Section 40-26B-71 Assessment. (a) For state fiscal years 2020, 2021, and 2022, an assessment
is imposed on each privately operated hospital in the amount of 6.00 percent of net patient
revenue in fiscal year 2017, which shall be reviewed and updated annually, subject to limitations
in this article on the use of funds in the Hospital Assessment Account. The assessment is
a cost of doing business as a privately operated hospital in the State of Alabama. Annually,
the Medicaid Agency shall make a determination of whether changes in federal law or regulation
have adversely affected hospital Medicaid reimbursement during the most recently completed
fiscal year, or a reduction in payment rates has occurred. If the agency determines that adverse
impact to hospital Medicaid reimbursement has occurred, or will occur, the agency shall report
its findings to the Chair of the House Ways and Means General Fund Committee who shall propose
an amendment to this article during any legislative session...
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40-26B-81
Section 40-26B-81 Medicaid hospital access payments. (a) If the Medicaid Agency begins
making payments pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30,
2019, to preserve and improve access to hospital services, for hospital inpatient and outpatient
services rendered on or after October 1, 2018, the agency shall consider the published inpatient
and outpatient rates as defined in Sections 40-26B-79 and 40-26B-80 as the minimum payment
allowed. (b) If the Medicaid Agency does not begin making payments pursuant to Article 9 of
Chapter 6 of Title 22, on or before September 30, 2019, the aggregate hospital access payment
amount is an amount equal to the upper payment limit, less total hospital base payments determined
under this article. All publicly, state-owned, and privately operated hospitals shall be eligible
for inpatient and outpatient hospital access payments for fiscal years 2020, 2021, and 2022,
as set forth in this article. (1) In addition to any other...
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40-26B-76
Section 40-26B-76 Notice of assessment. (a)(1) The department shall send a notice of
assessment to each privately operated hospital informing the hospital of the assessment rate,
the hospital's net patient revenue calculation, and the estimated assessment amount owed by
the hospital for the applicable fiscal year. (2) Annual notices of assessment shall be sent
at least 30 days before the due date for the first quarterly assessment payment of each fiscal
year. (b)(1) The privately operated hospital shall have 30 days from the date of its receipt
of a notice of assessment to review and verify the assessment rate, the hospital's net patient
revenue calculation, and the estimated assessment amount. (2) If a privately operated hospital
disputes the hospital's net patient revenue calculation and the estimated assessment amount,
the hospital shall notify the department of the disputed amounts within 15 business days of
notification of the assessment by the department. The hospital and the...
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40-26B-75
Section 40-26B-75 Quarterly notice and collection. (a)(1) The annual assessment imposed
under this article shall be due and payable on a quarterly basis during the first 15 business
days of each quarter. (2) Notwithstanding subdivision (1), the installment payment of an assessment
imposed by this article shall not be due and payable until: a. The department issues the written
notice required by this article stating that the payment methodologies to privately operated
hospitals required under this article have been approved by the Centers for Medicare and Medicaid
Services and the waiver under 42 C.F.R. §433.68 for the assessment imposed by this article,
if necessary, has been granted by the Centers for Medicare and Medicaid Services, or if approval
for the State Plan Amendment and the waiver under 42 CFR §433.68 for the assessment imposed
by this article, if necessary, is delayed for any reason, the payment shall be recalulated
by Medicaid upon actual approval; and b. The 30-day...
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40-26B-78
Section 40-26B-78 Certified public expenditure accounting. (a) Medicaid shall account
for those federal funds derived from certified public expenditures by publicly and state-owned
hospitals as those funds are received by Medicaid from the federal government. (b) The certified
public expenditure accounting shall be separate and distinct from the state General Fund appropriation
accounting. (c) Federal moneys accounted for shall not be used to replace other state General
Fund revenues appropriated and funded by the Legislature or other revenues used to support
Medicaid. (d) The moneys obtained by Medicaid from hospital certified public expenditure certifications
shall be used only as follows: (1) To make disproportionate share hospital payments under
this article; (2) To reimburse moneys collected by the department through error or mistake
under this article; or (3) For any other permissible purpose allowed under Title XIX of the
Social Security Act. (Act 2009-549, p. 1454, §2; Act...
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40-26B-83
Section 40-26B-83 State plan amendment. (a) There is established the Hospital Services
and Reimbursement Panel to advise in the development of and approve any state plan amendment
which involves hospital services or reimbursement to be submitted to the Centers for Medicare
and Medicaid Services. (1) The panel shall consist of six members and be constituted in the
following manner: a. The Commissioner of the Alabama Medicaid Agency. b. Three members to
be appointed by the Governor from a list of 10 names submitted by the Alabama Hospital Association.
The hospital members appointed shall represent the diverse ownership type of hospitals in
the state. c. Two members to be appointed by the Governor. (2) All panel members shall be
residents of Alabama and the composition of the board shall reflect the racial, gender, geographic,
urban/rural, and economic diversity of the state. The panel shall meet within 30 days subsequent
to May 15, 2009, to elect a chair and establish procedures...
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36-27-1
Section 36-27-1 Definitions. When used in this article, the following terms shall have
the following meanings, respectively, unless the context clearly indicates otherwise: (1)
RETIREMENT SYSTEM. The Employees' Retirement System of Alabama as defined in Section
36-27-2. (2) EMPLOYEE. Any regular employee of the State of Alabama whose salary is paid by
state warrant by the state, except a member of the Legislature of the state, a person who
is covered or eligible to be covered under the Teachers' Retirement System of Alabama or any
other retirement system to which contributions are made by the state, an elective official
of the state government, and a temporary employee or person engaged under retainer or special
agreement. In all cases of doubt the Board of Control shall determine who is an employee within
the meaning of this article. The term shall include any regular employee of the Alabama state
hospitals and Partlow State School and Hospital and the Alabama State Port Authority,...
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40-26B-26
Section 40-26B-26 Reduction of revenues; reimbursement computations; quality incentive
program. THIS SECTION WAS AMENDED BY ACT 2020-147 IN THE 2020 REGULAR SESSION, EFFECTIVE
MAY 18, 2020. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) No revenues resulting from the
privilege assessment established by this article and applied to increases in covered services
or reimbursement levels or other enhancements of the Medicaid program shall be subject to
reduction or elimination while the privilege assessment is in effect. (b) Every nursing facility
participating in the Medicaid program in the State of Alabama shall be reimbursed according
to the reimbursement methodology contained in Chapter 560-X-22 of the Alabama Medicaid Agency
Administrative Code (Supp. 12/31/95) on January 31, 1998, which methodology is incorporated
by reference herein, except that the following shall apply: (1) The ceiling for the operating
cost center described in Title 560-X-22-.06 (2)(a) of the Alabama Medicaid...
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