|
22-6-228
Section 22-6-228 Risk contracts. A risk contract between the Medicaid Agency and an integrated
care network shall be for two years, with the option for Medicaid to renew the contract for
not more than three additional one-year periods. The Medicaid Agency shall obtain provider
input and an independent evaluation of the cost savings, patient outcomes, and quality of
care provided by an integrated care network, and obtain the results of an integrated care
network's evaluation in time to use the findings to decide whether to enter into another multi-year
contract with the integrated care networks or change the Medicaid care delivery system associated
with an integrated care network. (Act 2015-322, §10.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-228.htm - 1017 bytes - Match Info - Similar pages
22-6-155
Section 22-6-155 Terms of contracts; cost evaluations. An initial contract between the Medicaid
Agency and a regional care organization shall be for three years, with the option for the
Medicaid Agency to renew the contract for not more than two additional one-year periods. The
Medicaid Agency shall obtain provider input and an independent evaluation of the cost savings,
patient outcomes, and quality of care provided by each regional care organization, and obtain
the results of each regional care organization's evaluation in time to use the findings to
decide whether to enter into another multi-year contract with the regional care organization
or change the Medicaid region's care-delivery system. (Act 2013-261, p. 686, §6; Act 2014-434,
p. 1598, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-155.htm - 1K - Match Info - Similar pages
22-6-91
Section 22-6-91 Definitions. For purposes of this article, the following words shall have the
following meanings: (1) HEALTHCARE SERVICES. Any services of the type for which the Medicaid
Agency may reimburse a provider. (2) PARTNERSHIP HOSPITAL PROGRAM. The Medicaid managed care
program for the provision of inpatient care in this state. (Act 2002-410, p. 1031, §2.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-91.htm - 694 bytes - Match Info - Similar pages
40-26B-85
Section 40-26B-85 Eligibility and benefit expansions. Except for Medicaid expansion under the
Affordable Care Act, as amended, if the Medicaid Agency elects to liberalize the eligibility
criteria for individuals who apply for Medicaid services or to expand or increase the medical
assistance benefits as defined in Title XIX of the Social Security Act which it currently
provides to Medicaid beneficiaries, the state share of such funds necessary to increase medical
assistance benefits or allow more persons to become eligible for Medicaid shall only be appropriated
from the state General Fund and not from any funds produced or segregated for hospital payments
under this article. (Act 2009-549, p. 1454, §2; Act 2019-278, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-85.htm - 1K - Match Info - Similar pages
22-6-158
Section 22-6-158 Contracts with service providers. A regional care organization shall contract
with any willing hospital, doctor, or other provider to provide services in a Medicaid region
if the provider is willing to accept the payments and terms offered comparable providers.
Any provider shall meet licensing requirements set by law, shall have a Medicaid provider
number, and shall not otherwise be disqualified from participating in Medicare or Medicaid.
(Act 2013-261, p. 686, §9.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-158.htm - 796 bytes - Match Info - Similar pages
34-23-183
Section 34-23-183 Application. This article shall apply to any audit of the records of a pharmacy
conducted by a managed care company, nonprofit hospital or medical service organization, health
benefit plan, third-party payor, pharmacy benefit manager, a health program administered by
a department of the state, except the Alabama Medicaid Agency, or any entity that represents
those companies, groups, or department. (Act 2012-306, p. 668, §4; Act 2018-457, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-183.htm - 779 bytes - Match Info - Similar pages
40-18-100
Section 40-18-100 Definitions. For the purposes of this article, the following terms shall
have the following meanings: (1) CLAIMANT AGENCY. Any of the following: a. The Alabama Commission
on Higher Education with respect to the collection of debts under either of the following:
1. The Alabama Student Grant Program provided for by Chapter 33A of Title 16. 2. The Alabama
Guaranteed Student Loan Program provided for by Chapter 33B of Title 16. b. The Alabama Department
of Human Resources with respect to the collection of debts and money owed under any and all
of its public assistance programs and other programs administered by that department, including
support programs administered pursuant to the requirements of Title IV-D of the Social Security
Act. c. The Alabama Medicaid Agency with respect to the collection of debts and money owed
under any and all of the programs it administers. d. The Alabama Department of Labor with
respect to the collection or recovery, or both, of debts owed...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-18-100.htm - 3K - 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-4
Section 40-26B-4 Filing of statement; penalty. (a) On or before the twentieth of each month,
beginning with November 1991, every pharmaceutical provider subject to this article shall
file with the department a statement under penalty of perjury on forms prescribed by the department,
showing the total number of prescriptions filled or refilled by said provider for the previous
month, the taxes due under this article and such other reasonable and necessary information
as the department, after consultation with the Alabama Medicaid Agency and adoption of appropriate
rules or regulations, may require for the proper enforcement of the provisions of this article.
At the time of filing such monthly statement such provider shall pay to the department the
amount of taxes shown to be due. When the total tax for which any pharmaceutical provider
liable under this article does not exceed $10 for any month, a quarterly return and remittance
in lieu of the monthly returns may be made on or before...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-4.htm - 2K - 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
|