|
40-26B-86
Section 40-26B-86 Disproportionate share payments. The Social Security Act provides for additional
payments to hospitals qualifying as disproportionate share hospitals under Section 1923(d)
of that act. Payments to disproportionate share hospitals shall be made to all hospitals qualifying
for disproportionate share hospital payments under Section 1923(d) of that act, in addition
to any other payments by Medicaid. Medicaid shall fully expend the allotment to hospitals
under Section 1923(f)(3) of the Social Security Act. Medicaid shall not restrict the qualifications
for disproportionate share hospital payments to anything less than what the act sets out as
disproportionate share hospital qualifications. The disproportionate share hospital payment
to each hospital shall be made quarterly during the first month of each quarter for the state
fiscal year. Medicaid shall mandate an uncompensated care survey be completed annually and
returned to Medicaid by each hospital affected by this...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-86.htm - 1K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-70.htm - 5K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-71.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-75.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-78.htm - 1K - Match Info - Similar pages
40-26B-60
Section 40-26B-60 Definitions. (a) For the purposes of this article the following words have
the following meanings unless the context clearly indicates otherwise: (1) DISPROPORTIONATE
SHARE HOSPITAL. A hospital meeting the requirements of Section 1923 of the Social Security
Act and other criteria adopted by the Alabama Medicaid Agency in its state plan for medical
assistance under Title XIX of the Social Security Act. (2) FISCAL YEAR. An accounting period
of 12 months beginning on the first day of the first month of the state fiscal year. (3) HOSPITAL.
A facility, which is licensed as a hospital under the laws of the State of Alabama, provides
24-hour nursing services, and is primarily engaged in providing, by or under the supervision
of doctors of medicine or osteopathy, inpatient services for the diagnosis, treatment, and
care or rehabilitation of persons who are sick, injured, or disabled. (4) PUBLICLY-OWNED HOSPITAL.
A hospital created and operating under the authority of a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-60.htm - 1K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-81.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-76.htm - 4K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-77.1.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-83.htm - 2K - Match Info - Similar pages
|