Home
News
About Medicaid
Long Term Care Workgroup
ALERTS
Boards & Committees
Calendar
News Articles
Publications
Procurement
Presentations
Regional Care Organizations
Statistics
Topics & Issues
Apply
General Information
Qualifying for Medicaid
Applications & Forms
Contacts & Locations
LTC Partnership Program
Apply Online
Expedite Online Nursing Home Application System
Programs
Health Homes
Covered Services
Long Term Care Services
Medical Services
Pharmacy Services / DME
Quality Initiatives
Meaningful Use
Transportation
Other Programs
Patient 1st
APEC - Perinatal Collaborative
Integrated Care Networks
Resources
A – Z Index
Administrative Code
Help/Search
Forms Library
Online Catalog
Site Map
State Plan
Links
Other State Medicaid Programs
Providers
Benefit Coordination/Third Party
Checkwrite Schedules
Vendor Companion Guides
Frequently Asked Questions
ICD-10
Fee Schedules
Manuals
News & Notices
Prior Authorization
Provider Electronic Solutions Software
Provider Enrollment
Release of Information
CAQH CORE Operating Rules
Secure Web Portal - Logon
Fraud
What is Fraud & Abuse?
Medicaid Program Integrity Division
Consumer Protection & Privacy
Preventing Fraud - Recipients
Preventing Fraud - Providers
Reporting Fraud and Abuse
Suspended Providers
Recovery Audit Contractor Audits
Provider Education Checklists
Contact
Medicaid Contacts
HP Contact Information
Contact Information for Applicants
Electronic Media Claims Helpdesk
Provider Assistance Center
Provider Enrollment
Recipients
My Medicaid
Apply Online
Applicant/Recipient Forms
Change Patient 1st Doctor
Educational Documents
Helpful Links
Privacy
Spanish-Language Documents
Advance Directives
Update Health Insurance Info
Frequently Asked Questions
Reference
Medicaid Staff login
About Medicaid
Administrative Code
Checkwrite schedule
Covered Services/Co-pays
Manuals
State Plan
Alabama Medicaid State Plan 

The Medicaid State Plan outlines the organization and function of the Alabama Medicaid Agency.  Amendments to the State Plan (SPAs) are required when changes to amount, duration or scope of services, or eligibility requirements are proposed.

Proposed state plan amendments


  Entire State Plan (PDF) - Bookmarked document
Note: Large file may take a few minutes to download
  Table of Contents
Sections  
Section 1 Single State Agency Organization
Section 2 Coverage and Eligibility
Section 3 Services, General Provisions
Section 4 General Program Administration
Section 5 Personnel Administration
Section 6 Financial Administration
Section 7 General Provisions
Attachments  
1.1-A Attorney General's Certification
1.2-A Organization and Functions of State Agency
1.2-B

Organization and Functions of the Alabama Medicaid Agency

1.2-C Professional Medical Personnel and Supporting Staff
1.2-D Eligibility Determination Staff and Functions
2.1-A Definition of a Health Maintenance Organization
2.2-A Groups Covered and Agencies Responsible for Eligibility Determination
2.6-A Eligibility Conditions and Requirements
Supplemental 2.6-A Income Eligibility Levels
Supplemental 8-A to 2.6-A Methods of Treating Income
2.6-B Standards for Optional State Supplementary Payments
3.1-A Amount, Duration, and Scope of Medical and Remedial Care and Services Provided to the Categorically Needy
Supplemental 3.1-A Targeted Case Management Services
3.1-B Amount, Duration and Scope of Services Provided Medically Needy Group(s)
3.1-C Methods for Assuring High Quality of Care
3.1-D Methods for Providing Transportation
3.1-E Standards for the Coverage of Organ Transplant Services
3.1-F Managed Care
3.1-H Health Homes for Individuals with Chronic Conditions
3.2-A Coordination of Title XIX with Part A and Part B of Title XVIII
3.5-A Medicaid for Medicare Cost Sharing for Qualified Medicare Beneficiaries
4.11-A Standards for Medical Institutions
4.14-B Utilization Review in Intermediate Care Facilities
4.16-A Cooperative Arrangements with Other Agencies
  Agreements
4.17-A Liens and Adjustments or Recoveries
4.18-A Service Charges for the Categorically Needy
4.18-D Premiums Imposed on Low Income Pregnant Women and Infants
4.18-E Optional Sliding Scale Premiums Imposed on Qualified Disabled and Working Individuals
4.19-A Method for Payment of Reasonable Costs Inpatient Hospital Services
4.19-B Payment for Medical Care and Services Excluding Inpatient Hospital and Long Term Care Services
4.19-C Policy on Payment for Reserving Beds in an Impatient Facility
4.19-D Methods and Procedures for Determining Nursing Facility Reimbursement
4.19-E Definition of a Claim
4.22-A Requirements for Third Party Liability - Identifying Liable Resources
4.22-B Third Party Collection Procedures to be Cost Effective
4.22-C State Method on Cost Effectiveness of Employer-Based Group Health Plans Private Health Insurance Buy In (PHIBI)
4.30 Sanctions for Psychiatric Hospitals
4.32-A Income and Eligibility Verification System Procedures Requests to Other State Agencies
4.33-A Method for Issuance of Medicaid Eligibility Cards to Homeless Individuals
4.34-A Requirements for Advanced Directives Under State Plans for Medical Assistance
4.35-A-H Eligibility Conditions and Requirements - Enforcement of Compliance for Nursing Facilities
4.38-A Disclosure/Collection of Additional Registry Information
4.39-A Definition of Specialized Services/CategoricalDeterminations
4.40-A-E Eligibility Conditions and Requirements -Various
4.42-A Employee Education about False Claims Recoveries
4.43 Cooperation with Medicaid Integrity Program Efforts
7.2-A Statement of Compliance Certification for the Medical Assistance Program of Alabama
   

To search within an Adobe Acrobat Reader file:

1. Open the Adobe file.
2. An Adobe toolbar appears.
3. Click on the Find button (picture of the binoculars) on the Adobe toolbar.
4. Type the word or phrase you want to search for.
5. Choose your options as needed.
6. Click the Find button.
7. Your word or phrase will appear selected in the Adobe file.
8. If you wish to search again for the same word or phrase, click the Find Again button (smaller binoculars with an arrow).