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 fiscal year 2019 for outpatient services based upon a fee for service and access payments or OPPS schedule. 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 2023, there shall be no retroactive adjustment to payments already made to hospitals in accordance with the approved state plan.
Should the Medicaid Agency implement OPPS, the total amount budgeted (total base rate) for OPPS shall not be less than the total outpatient UPL.
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 agency shall pay hospitals as a base amount for fiscal years 2023, 2024, and 2025 for outpatient services, based upon an outpatient fee schedule in existence on September 30, 2018. Medicaid may update the outpatient fee schedule with approval of the Hospital Services and Reimbursement Panel. Hospital outpatient base payments shall be in addition to any hospital access payments or other payments described in this article.
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.