Dec. 3, 2012
Medicaid announces enrollment requirements for providers who order, prescribe and refer
Effective Jan. 1, 2013, federal law requires that all physicians and other practitioners who prescribe or order services for Medicaid recipients, or who refer Medicaid recipients to other providers, be enrolled as a Medicaid provider. As a result of this federal law, services rendered based on referral, order, or prescription will be reimbursable only if the ordering, prescribing, or referring (OPR) physician/practitioner is enrolled in the Alabama Medicaid Program.
An enrollment application was developed for those providers who do not treat Alabama Medicaid recipients for payment, but who do order, prescribe or refer. The application is located on the Alabama Medicaid Agency website at the following link in the Administrative Forms section
For more information on OPR and how to enroll as a provider in the Alabama Medicaid Program, please visit the Alabama Medicaid website at www.medicaid.alabama.gov.
February 10, 2011
Qualifying for Medicaid's EHR Incentive Payment
To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:
• Have a minimum 30% Medicaid patient volume*
• Have a minimum 20% Medicaid patient volume, and is a pediatrician*
• Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals
* Children’s Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria. Patient 1st and dual eligibles do count.
The Medicaid EHR Incentive program pays up to $63,750 over a five-year period. In year one, receive payment of $21,250 for adopting, implementing or upgrading an EHR. (No reporting period required.)
Registration for Medicaid's EHR incentive program is slated to begin April 1. Read more
Why become a meaningful user?
Instructions for obtaining the CMS EHR Certification Number
Medicaid announces changes to Radiology Managment "Gold Card" program
Effective Jan. 1, 2011, changes will be made to the Alabama Medicaid Agency’s Radiology Management Program “Gold Card” status based on agency evaluation of prior authorization requests made between Oct. 1, 2009, and Sept. 30, 2010.
March 22, 2010
State awarded grant to build electronic health record system
Governor Bob Riley has announced that Alabama will receive $10.5 million in federal funds to build an electronic health information system that can be used by public and private healthcare providers.
The $10.5 million will be made available in the form of a cooperative agreement over a four-year period at matching rates ranging from 100 percent federal funds in the current fiscal year to 30 percent federal funds in the fourth year of the project. Read more
March 22, 2010
Medicaid agency official pleased with savings from Radiology Management Program
The Alabama Medicaid Agency says that initial reports from its radiology management program indicate that the agency saved an estimated $1 million in the first quarter after initiating the Radiology Management Program in March 2009. Read more
February 3, 2010
Medicaid to require electronic submission of claims, recipient eligibility verification
Effective March 1, all claims not requiring attachments or administrative review override must be submitted electionally.
In addition Medicaid recipient eligibility must also be checked electronically as of March 1. Read more
January 14, 2010
Effective July 1, Alabama Medicaid will require NDC numbers on all physician administered drugs
In 2008, the Alabama Medicaid Agency began requiring the NDC number for the top physician-administered multiple source drugs. Effective July 1, 2010, the NDC number will be mandatory on ALL physician-administered drugs in certain ranges.
Certain drug manufacturers provide a rebate to Medicaid for physician-administered drugs, so the agency is encouraging physicians to utilize drugs manufactured by these companies. In the future, these drugs will be the only ones Medicaid will cover for payment. Read more
Medicaid is a program jointly funded by the state and federal governments that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other eligibility requirements.
EPSDT - Well Child Checkup Program
SOBRA - Maternity and Child coverage
Child Caring Foundation
For More Information
Alabama Medicaid Agency
Alabama Medicaid Agency News
Bringing Better Health to Life (Overview of Medicaid Program)
Fee Schedule Search
Preferred Drug List
November 30, 2010