Code of Alabama
Title 1 - Health and Environmental Control Generally.
Chapter 6 - Medicaid Program.

Section 22-6-4 - Copayments by Persons Receiving Medical Services From Physicians Under Program. - (a) All persons eligible to receive Medicaid shall pay the...

Section 22-6-4.1 - Copayments by Persons Receiving Medical Services From Physicians or Other Medical Practitioners Under Program. - (a) Medicaid eligible persons shall pay a $2.00 copayment for...

Section 22-6-4.2 - Copayments for Prescription Drugs. - (a) Medicaid eligible persons shall pay the maximum allowable copayment...

Section 22-6-5.1 - Collection of Patient's Income by Tax Collector; Payment to Medicaid Agency; Exceptions; Rules and Regulations. - Repealed by Act 2015-70 effective April 21, 2015.

Section 22-6-6 - Subrogation of State to Rights of Recipients of Medical Assistance Under Program Against Persons, etc., Causing Injury, etc., Thereto; Manner of Enforcement of Rights of State; Effect of Action by State or Recipient Against Person, e... - (a) If medical assistance is provided to a recipient under...

Section 22-6-6.1 - Assignment to State of Recipients' Rights to Payments for Medical Care; Authorization to Release Needed Information. - (a) Every recipient of medical assistance under the Alabama Medicaid...

Section 22-6-7 - Medicaid Agency Authorized to Contract With Fiscal Intermediaries for Purpose of Receiving, Processing, and Paying Claims. - (a) The Medicaid Agency of the State of Alabama, the...

Section 22-6-7.1 - Procurement of Prescription Eyewear. - Contracts for the procurement of prescription eyewear for recipients of...

Section 22-6-8 - Revocation of Eligibility of Recipient Upon Determination of Abuse, Fraud, or Misuse of Benefits; When Eligibility May Be Restored; Award of Restricted Status to Pregnant Recipient Whose Eligibility Has Been Revoked. - (a) Upon determination by a utilization review committee of the...

Section 22-6-9 - Medicaid Identification Card; Issuance and Use; Confidentiality of Recipient. - (a) The Department of Human Resources shall issue to all...

Section 22-6-10 - Women's Right to Health Care. - (a) This section shall be known and may be cited...

Section 22-6-11 - Breast and Cervical Cancer Prevention and Treatment. - (a) This section shall be known and may be cited...

Section 22-6-12 - Suspension of Eligibility for Inmates of Certain Public Institutions; Temporary Reinstatement. - (a) An inmate of a public institution under the administrative...

Section 22-6-13 - Medicaid Benefits for County Inmates and Certain Juveniles. - (a) For the purposes of this section, the following words...

Section 22-6-14 - Autism Spectrum Disorder Coverage and Reimbursement Under Alabama Medicaid Program. - In the administration of and provision of benefits for the...

Article 2 - Long Term Quality Health Care Act.

Section 22-6-20 - Legislative Intent. - The Legislature recognizes the increasing population of our senior citizens...

Section 22-6-21 - Short Title. - This article shall be known as "The Long Term Quality...

Section 22-6-22 - Reference to Federal Law. - Any reference contained in this article to federal law or...

Section 22-6-23 - "Facility" Defined. - Where referred to in this article, facility shall mean intermediate...

Section 22-6-24 - Responsible Agency; Deposit of Funds; Appropriation. - Medicaid is designated as the agency responsible to ensure compliance...

Section 22-6-25 - Enforcement Remedies; Adoption of Criteria. - Medicaid shall have such specific civil remedies of enforcement as...

Section 22-6-26 - Health Department Functions and Responsibilities. - This article shall in no way supersede, replace or affect...

Section 22-6-27 - Resident Protection Trust Fund; Appropriation; Use. - All revenue collected pursuant to assessing civil penalties shall be...

Article 3 - Health Care Trust Fund.

Section 22-6-30 - Fund Established; Purpose. - There is hereby established the Alabama Health Care Trust Fund...

Section 22-6-31 - Moneys in Fund Appropriated to Alabama Medicaid Agency. - All moneys deposited in said fund shall be available solely...

Section 22-6-32 - Unobligated Balance Not to Revert to General Fund but to Be Carried Forward. - Any unobligated balance in said fund shall not revert to...

Article 4 - Obstetrics, Pediatrics, and Family Practice Financing and Insurance Premium Adjustments.

Section 22-6-40 - Medicaid Agency Authorized to Increase Financing and Adjust Insurance Premiums for Family Practitioners, Pediatricians and Obstetricians. - The Legislature recognizes the shortage of and the decline in...

Section 22-6-41 - Availability of Increased Financing. - This financing shall be available to physicians in family practice,...

Section 22-6-42 - Administration of Financing Program; Establishment of Rules and Criteria for Alleviating Rural Problems and Reducing High Infant Mortality Rates. - The Alabama Medicaid Agency is hereby authorized to develop and...

Article 6 - Medicaid Trust Fund.

Section 22-6-70 - Created. - There is hereby created in the State Treasury a trust...

Section 22-6-71 - Board of Directors. - The Medicaid Trust Fund Board of Directors shall be composed...

Section 22-6-72 - Duties of State Treasurer; Disposition of Funds. - The State Treasurer shall invest the funds in the trust...

Section 22-6-73 - Powers of Board. - The board of directors of the trust fund shall have...

Article 7 - Medicaid Revenue Use Act.

Section 22-6-90 - Short Title. - This article shall be known as the "Medicaid Revenue Use...

Section 22-6-91 - Definitions. - For purposes of this article, the following words shall have...

Section 22-6-92 - Use of Funds; Annual Certification. - Any hospital or hospital system located in the State of...

Section 22-6-93 - Transfer of Funds - Generally. - To the extent any hospital or hospital system transfers, directly...

Section 22-6-94 - Transfer of Funds - Use by Medicaid Agency. - All funds transferred by a hospital or a hospital system...

Section 22-6-95 - Transfer of Funds - Annual Certification. - At the time a hospital or hospital system transfers funds...

Section 22-6-96 - Transfer of Funds - Return of Uncertified Funds. - In the event a hospital or hospital system transfers funds...

Section 22-6-97 - Transfer of Funds - Return of Noncomplying Funds. - In the event a hospital or hospital system transfers funds...

Section 22-6-98 - Rules and Regulations. - The Commissioner of the Medicaid Agency may adopt and implement...

Article 8 - Medicaid Preferred Drug Plan.

Section 22-6-120 - Legislative Findings. - The Legislature finds the following: (1) The availability of appropriate...

Section 22-6-121 - Medicaid Pharmacy and Therapeutics Committee - Composition; Meetings. - (a) The Alabama Medicaid Agency shall utilize a Medicaid Pharmacy...

Section 22-6-122 - Medicaid Pharmacy and Therapeutics Committee - Classification and Recommendation of Drugs; Assurance of Quality Patient Care; Review of Pharmaceutical Products. - (a) The Medicaid Pharmacy and Therapeutics Committee shall review and...

Section 22-6-123 - Considerations for Inclusions on Preferred Drug List; Review; Adoption of List. - (a) Drugs will be considered for the Medicaid preferred drug...

Section 22-6-124 - Confidentiality of Information. - Notwithstanding any other law to the contrary, all information and...

Article 9 - Delivery of Medical Services.

Section 22-6-150 - Definitions. - For the purposes of this article, the following words shall...

Section 22-6-151 - Regional Care Organizations; Governing Board of Directors; Citizen's Advisory Committee; Solvency and Financial Requirements; Reporting; Provider Standards Committee. - (a) A regional care organization shall serve only Medicaid beneficiaries...

Section 22-6-152 - Medicaid Regions. - The Medicaid Agency shall establish by rule geographic Medicaid regions...

Section 22-6-153 - Contract to Provide Medical Care to Medicaid Beneficiaries; Enrollment; Grievance Procedures; Duties of Medicaid Agency. - (a) Subject to approval of the federal Centers for Medicare...

Section 22-6-154 - Quality Assurance Committee; Collection and Publication of Information. - (a) The Medicaid Agency shall create a quality assurance committee...

Section 22-6-155 - Terms of Contracts; Cost Evaluations. - An initial contract between the Medicaid Agency and a regional...

Section 22-6-156 - Contracts With Alternate Care Providers. - The Medicaid Agency may contract with an alternate care provider...

Section 22-6-157 - Termination of Regional Care Organization Certification. - (a) The Medicaid Agency shall establish by rule the procedure...

Section 22-6-158 - Contracts With Service Providers. - A regional care organization shall contract with any willing hospital,...

Section 22-6-159 - Implementation of Article. - (a) The following is the timeline for implementation of this...

Section 22-6-160 - Evaluation and Report on Long-Term Care System for Medicaid Beneficiaries. - The Medicaid Agency shall decide which groups of Medicaid beneficiaries...

Section 22-6-161 - Evaluation and Report on Dental Care Program for Medicaid Beneficiaries. - (a) The Medicaid Agency, with input from dental care providers,...

Section 22-6-162 - Case-Management Services. - The Medicaid Agency may contract for case-management services with an...

Section 22-6-163 - Legislative Findings; Rules; Collaboration; Approval of Agreements and Contracts; State Action Immunity; Confidentiality of Records; Additional Duties. - (a) The Legislature declares that collaboration among public payers, private...

Section 22-6-164 - Rulemaking Authority. - The Medicaid Agency may adopt rules necessary to implement this...

Section 22-6-165 - Regional Care Organizations Exempt From Certain License Fees. - Any provision of law to the contrary notwithstanding, regional care...

Article 10 - Pace Program in Class 2 Municipality.

Section 22-6-190 - Applicability. - This article shall apply only in a Class 2 municipality...

Section 22-6-191 - Legislative Intent. - The intent of this article is to allow the only...

Section 22-6-192 - Definitions. - For the purposes of this article, the following words have...

Section 22-6-193 - Licensing Requirements; Promulgation of Rules. - Each PACE provider providing services in a Class 2 municipality...

Section 22-6-194 - Privilege Assessment - Authorized on Business Activities of Certain Pace Program Providers. - To provide further for the availability of indigent health care...

Section 22-6-195 - Privilege Assessment - Payment; Disposition of Funds. - (a) The assessment imposed by this article shall be due...

Section 22-6-196 - Privilege Assessment - Failure to Pay. - Any PACE provider that fails to pay the assessment levied...

Section 22-6-197 - Privilege Assessment - Recordkeeping; Promulgation of Rules. - (a) It shall be the duty of each PACE provider...

Section 22-6-198 - Privilege Assessment - Use of Revenues; Reimbursements. - (a) The Medicaid Agency shall use the revenues from the...

Section 22-6-199 - Privilege Assessment - Reduction or Elimination of Revenues. - No revenues resulting from the assessment established by this article...

Section 22-6-200 - Federal Financial Participation; Contract for Services. - This article shall be of no effect if federal financial...

Article 11 - Integrated Care.

Section 22-6-220 - Definitions. - For the purposes of this article, the following words shall...

Section 22-6-221 - Service by Integrated Care Network; Board of Directors. - (a) An integrated care network shall serve only Medicaid beneficiaries...

Section 22-6-222 - Citizens' Advisory Committee. - There shall be a citizens' advisory committee constituted to advise...

Section 22-6-223 - Solvency and Financial Requirements. - (a) An integrated care network shall meet minimum solvency and...

Section 22-6-224 - Medicaid Agency to Contract for Medical Care; Enrollment; Delivery of Services; Reimbursement. - (a) Subject to approval of the federal Centers for Medicare...

Section 22-6-225 - Denial of Claims; Grievances and Appeals. - (a) The Medicaid Agency shall establish by rule procedures for...

Section 22-6-226 - Review and Approval of Contracts; Rules Governing Operation of Integrated Care Networks. - (a) All provider contracts of an organization granted final certification...

Section 22-6-227 - Quality Assurance Committee; Reporting Requirements. - (a) The Medicaid Agency shall create a quality assurance committee...

Section 22-6-228 - Risk Contracts. - A risk contract between the Medicaid Agency and an integrated...

Section 22-6-229 - Termination of Certification. - (a) The Medicaid Agency shall establish by rule the procedure...

Section 22-6-230 - Rates for Contracting Services; Provider Requirements. - An integrated care network shall contract with any willing nursing...

Section 22-6-231 - Implementation of Article. - (a) The following timeline applies to implementation of this article:...

Section 22-6-232 - Coverage of Medicaid Beneficiaries by Integrated Care Networks. - (a) The Medicaid Agency shall determine by rule which groups...

Section 22-6-233 - Legislative Findings; Certification of Collaborators; Powers of Medicaid Agency; State Action Immunity. - (a) The Legislature declares that collaboration among public payers, private...

Section 22-6-234 - Advance Directive for Health Care Options. - Any participant in the integrated care network system receiving long...

Section 22-6-235 - Rulemaking Authority. - The Medicaid Agency shall adopt rules necessary to implement this...

Section 22-6-236 - Construction and Application of &Sect;§22-6-220 Through 22-6-234. - All laws or parts of laws which conflict with this...

Section 22-6-237 - Exemption From Certain Fees and Taxes. - Any other provision of law to the contrary notwithstanding, integrated...

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Code of Alabama Title 1 - Health and Environmental Control Generally. Chapter 6 - Medicaid Program.

Code of Alabama
Title 1 - Health and Environmental Control Generally.
Chapter 6 - Medicaid Program.