Alabama Code 40-26B-80. Outpatient Medicaid base payments
Terms Used In Alabama Code 40-26B-80
- Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
- state: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Alabama Code 1-1-1
- year: means a calendar year; but, whenever the word "year" is used in reference to any appropriations for the payment of money out of the treasury, it shall mean fiscal year. See Alabama Code 1-1-1
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.