THIS SECTION WAS AMENDED BY ACT 2022-127 IN THE 2022 REGULAR SESSION, EFFECTIVE OCTOBER 1, 2022. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT.
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, 2025, the agency shall pay hospitals as a base amount for fiscal years 2023, 2024, and 2025, the greater of a hospital's current per diem as published for fiscal year 2022 or 68 percent of total inpatient payments made by the agency during state fiscal year 2019, divided by the total patient days paid in state fiscal year 2019, multiplied by patient days paid during fiscal years 2023, 2024, and 2025. A hospital may request to have their per diem reviewed and revised at the sole discretion of the Medicaid Agency. This payment to be paid using the agency's published check write table is in addition to any hospital access payments the agency may elect to pay hospitals as inpatient payments other than per diems and access payments, if the agency does not make payments pursuant to Article 9 of Chapter 6 of Title 22 in fiscal year 2019, or fiscal years 2023, 2024, and 2025, only if the Hospital Services and Reimbursement Panel approves the change in hospital payments.
Structure Code of Alabama
Title 40 - Revenue and Taxation.
Chapter 26B - Providers of Medical Services Privilege Tax.
Article 5 - Hospital Funding Program.
Section 40-26B-70 - Definitions.
Section 40-26B-71 - Assessment.
Section 40-26B-72 - Program Administration.
Section 40-26B-73 - Hospital Assessment Account.
Section 40-26B-74 - Private Hospital Assessment.
Section 40-26B-75 - Quarterly Notice and Collection.
Section 40-26B-76 - Notice of Assessment.
Section 40-26B-77 - Hospital Certified Public Expenditures.
Section 40-26B-77.1 - Intergovernmental Transfers to the Medicaid Agency.
Section 40-26B-78 - Certified Public Expenditure Accounting.
Section 40-26B-79 - Inpatient Medicaid Base Payments.
Section 40-26B-80 - Outpatient Medicaid Base Payments.
Section 40-26B-81 - Medicaid Hospital Access Payments.
Section 40-26B-82 - Effectiveness and Cessation.
Section 40-26B-83 - State Plan Amendment.
Section 40-26B-84 - Federal Medical Assistance Percentage.
Section 40-26B-85 - Eligibility and Benefit Expansions.
Section 40-26B-86 - Disproportionate Share Payments.