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40-26B-80
Section 40-26B-80 Outpatient Medicaid base payments. If the Medicaid Agency begins making payments
pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2019, the agency
shall pay hospitals as a base amount for fiscal year 2019 for outpatient services based upon
a fee for service and access payments or OPPS schedule. If the agency begins making payments
pursuant to Article 9 of Chapter 6 of Title 22, on a date other than the first day of fiscal
year 2022, there shall be no retroactive adjustment to payments already made to hospitals
in accordance with the approved state plan. Should the Medicaid Agency implement OPPS, the
total amount budgeted (total base rate) for OPPS shall not be less than the total outpatient
UPL. 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 agency shall pay hospitals as a base amount
for fiscal year 2019 for outpatient services, based upon an...
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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-79
Section 40-26B-79 Inpatient Medicaid base payments. If the Medicaid Agency begins making payments
pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2019, the agency
shall pay hospitals as a base amount for state fiscal year 2019, for inpatient services an
APR-DRG payment that is equal to the total modeled UPL submitted and approved by CMS during
fiscal year 2019. If the agency begins making payments pursuant to Article 9 of Chapter 6
of Title 22, on a date other than the first day of fiscal year 2019, there shall be no retroactive
adjustment to payments already made to hospitals in accordance with the approved state plan.
If approved by CMS, the agency shall publish the APR-DRG rates for each hospital prior to
September 30, 2018. If the agency does not begin making payments pursuant to Article 9 of
Chapter 6 of Title 22, on or before September 30, 2022, the agency shall pay hospitals as
a base amount for fiscal years 2020, 2021, and 2022, the total inpatient...
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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-77.1
Section 40-26B-77.1 Intergovernmental transfers to the Medicaid Agency. (a) Beginning on October
1, 2016, and ending on September 30, 2022, publicly owned and state-owned hospitals shall
begin making intergovernmental transfers to the Medicaid Agency. If the agency begins making
payments pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2019,
the amount of the intergovernmental transfers shall be calculated for each hospital using
a pro-rata basis based on the hospital's IGT contribution for FY 2018 in relation to the total
IGT for FY 2018. Total IGTs for any given fiscal year shall not exceed three hundred thirty-three
million, four hundred thirty-four thousand, and forty-eight dollars ($333,434,048) with the
exception of an adjustment as described in subsection (d) and to the extent adjustments are
required to comply with federal regulations or terms of any waiver issued by the federal government
relating to the state's Medicaid program. The total...
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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-70
Section 40-26B-70 Definitions. For purposes of this article, the following terms shall have
the following meanings: (1) ACCESS PAYMENT. A payment by the Medicaid program to an eligible
hospital for inpatient or outpatient hospital care, or both, provided to a Medicaid recipient.
(2) ALL PATIENT REFINED DIAGNOSIS-RELATED GROUP (APR-DRG). A statistical system of classifying
any non-Medicare inpatient stay into groups for the purposes of payment. (3) ALTERNATE CARE
PROVIDER. A contractor, other than a regional care organization, that agrees to provide a
comprehensive package of Medicaid benefits to Medicaid beneficiaries in a defined region of
the state pursuant to a risk contract. (4) CERTIFIED PUBLIC EXPENDITURE (CPE). A certification
in writing of the cost of providing medical care to Medicaid beneficiaries by publicly owned
hospitals and hospitals owned by a state agency or a state university plus the amount of uncompensated
care provided by publicly owned hospitals and hospitals...
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25-4-51
Section 25-4-51 Rates of contributions, etc., by employers. (a) Contributions. Except as hereinafter
provided and subject to the provisions of Section 25-4-54, every employer shall pay contributions,
or payments in lieu of contributions, equal to the percentages of wages payable or paid as
hereinafter set out, with respect to employment by him. (1) With respect to employment during
calendar years after December 31, 1975, every employer who has been liable to the provisions
of this chapter during a period of time sufficient to have his rate of contribution determined
under the experience rating provisions of Section 25-4-54 shall pay contributions at the rate
prescribed thereby. (2) With respect to employment after December 31, 1975, every employer
who has not been liable to the provisions of this chapter for a sufficient length of time
to have his rate determined under the experience rating provisions of Section 25-4-54 shall
pay contributions at the rate of 2.70 percent of such wages...
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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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45-23-171
Section 45-23-171 Individuals with mental illness taken into temporary protective custody.
(a) For the purposes of this section, the following terms have the following meanings: (1)
DESIGNATED LAW ENFORCEMENT AGENCY. A law enforcement agency within Dale County that is authorized
by the sheriff to exercise the authority described in this section. (2) LAW ENFORCEMENT OFFICER.
Any state, county, or municipal officer certified by the Alabama Peace Officers' Standards
and Training Commission. (b)(1) Concurrently with Article 1 of Chapter 52 of Title 22, a law
enforcement officer from a designated law enforcement agency may take an individual into protective
custody when the officer has reasonable cause to believe that the individual is mentally ill
and is an immediate danger to himself or herself or others. (2)a. Upon placement of an individual
under protective custody pursuant to subdivision (1), the law enforcement officer shall transport
the individual to a hospital providing care and...
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