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27-21B-9
Section 27-21B-9 Garnishment of wages. (a) The Alabama Medicaid Agency may garnish the wages,
salary, or other employment income of any person who is required by a court or administrative
order to provide coverage of the costs of health services to a child who is eligible for medical
assistance and has received payment from a third party for the cost of services for the child
but has not used the payments to reimburse the other parent or guardian of the child, the
provider of services, or the Alabama Medicaid Agency for its payments made. Current or past
due child support shall have priority over claims for the costs of the services. (b) In addition
to the powers granted in subsection (a), the Alabama Medicaid Agency may notify the State
Department of Revenue of any amounts due under this section. Upon proper and timely notice,
the department shall withhold any amount from any state tax refund due to the above-described
person. (Acts 1994, No. 94-710, p. 1377, ยง9.)...
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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-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-21
Section 40-26B-21 Privilege assessment on nursing facilities. To provide further for the availability
of indigent health care, the operation of the Medicaid program, and the maintenance and expansion
of medical services: (a) There is levied and shall be collected a privilege assessment on
the business activities of every nursing facility in the State of Alabama. The privilege assessment
imposed is in addition to all other taxes and assessments, and shall be at the annual rate
of one thousand eight hundred ninety-nine dollars and ninety-six cents ($1,899.96) for each
bed in the nursing facility. Beginning September 1, 2020, the privilege assessment shall be
increased from one thousand eight hundred ninety-nine dollars and ninety-six cents ($1,899.96)
for each bed in the nursing facility, by an addition to the privilege assessment equal to
three hundred twenty-seven dollars and forty-eight cents ($327.48) per annum. The addition
to the privilege assessment shall be paid in equal monthly...
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41-5A-6
Section 41-5A-6 Chief examiner - Recovery audits for overpayments of state funds. (a) For the
purposes of this section, the following words have the following meanings: (1) CHIEF EXAMINER.
The Chief Examiner of Public Accounts. (2) OVERPAYMENT. Any payment in excess of amounts due
and includes failure to meet eligibility requirements, failure to identify third party liability
where applicable, any payment for an ineligible good or service, any payment for a good or
service not received, duplicate payments, invoice and pricing errors, failure to apply discounts,
rebates, or other allowances, failure to comply with contracts or purchasing agreements, or
both, failure to provide adequate documentation or necessary signatures, or both, on documents,
or any other inadvertent error resulting in overpayment. (3) RECOVERY AUDIT. A financial management
technique used to identify overpayments made by a state agency with respect to individuals,
vendors, service providers, and other entities in...
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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-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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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency makes
periodically to the integrated care network on behalf of each recipient enrolled under a contract
for the provision of medical services pursuant to this article. (2) COLLABORATOR. A private
health carrier, third party purchaser, provider, health care center, health care facility,
state and local governmental entity, or other public payers, corporations, individuals, and
consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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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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22-6-150
Section 22-6-150 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) 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. (2) CAPITATION
PAYMENT. A payment the state Medicaid Agency makes periodically to a contractor on behalf
of each recipient enrolled under a contract for the provision of medical services. (3) CARE
DELIVERY SYSTEM. The manner in which the benefits and services set forth in the state Medicaid
plan are provided to Medicaid beneficiaries. (4) COLLABORATOR. A private health carrier, third
party purchaser, provider, health care center, health care facility, state and local governmental
entity, or other public payers, corporations, individuals, and consumers who are expecting
to collectively cooperate, negotiate, or contract with another...
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