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Medicaid eligibility and enrollment in Alabama Learn who’s eligible to enroll in Alabama's Medicaid program, how to apply, the status of Medicaid expansion and the effects of Medicaid disenrollment.

"Childless adults in Alabama are not eligible for Medicaid, because the state has not expanded Medicaid under the ACA. And parents of minor children are only eligible with extremely low incomes."

#AlabamaMedicaid #Medicaid #insurance

www.healthinsurance.org/medicaid/ala...

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Coverage update for 97550 – 97552 and 92609 [Medicaid] Effective October 1, 2025, the Alabama Medicaid Agency will update coverage of procedure codes 97550-97552 and 92609.

AL. State Agencies:Alabama News Beacon #Medicaid #AlabamaMedicaid #HealthcareUpdates #ProcedureCodes #MedicaidCoverage

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Alabama Medicaid

"Medicaid must be renewed every year. Stay up to date about changes that can affect your benefits. To get notified, update your mailing address and other information with the Alabama Medicaid Agency as soon as possible."

#AlabamaMedicaid #Medicaid

medicaid.alabama.gov/content/11.0...

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Billing for Items and Services in Connection with Dental Care Provided [Medicaid] Effective for dates of service on and after November 1, 2023, the Alabama Medicaid Agency (Medicaid) will reimburse for G0330 - facility services for dental rehabilitation procedures. Hospitals should use G0330 to bill for the use of an operating room, items, and services in connection with dental care provided in a hospital setting. Medicaid will reimburse G0330 at $1,205.70.

AL. State Agencies:Alabama News Beacon #DentalCare #Medicaid #HealthCare #AlabamaMedicaid #DentalRehab

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Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease [Medicaid] Effective November 1, 2023, the Alabama Medicaid Agency will implement hard edits on cumulative daily MME claims exceeding 150 MME/day. A phase-in period for claims exceeding 120 MME/day, but less than 150 MME/day, will also be implemented.

AL. State Agencies:Alabama News Beacon #OpioidCrisis #MME #AlabamaMedicaid #PainManagement #HealthcarePolicy

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Public Forum set for input on Medicaid’s SMI 1115 Demonstration Waiver [Medicaid] Providers, recipients, and other interested individuals will have the opportunity to provide input on the Alabama Medicaid Agency Section 1115 Institutions for Mental Disease Waiver for Serious Mental Illness (SMI) 1115(a) Demonstration program during November public forums in Daphne, AL and Montgomery, AL.

AL. State Agencies:Alabama News Beacon #Medicaid #MentalHealth #PublicForum #SMIWaiver #AlabamaMedicaid

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Recipients Should Complete Medicaid Renewal Forms [Medicaid] The Alabama Medicaid Agency has published a PSA video to encourage Medicaid recipients to complete their eligibility renewal forms when their notices come in the mail. Medicaid providers and partners are encouraged to share this video in public locations and on websites.

AL. State Agencies:Alabama News Beacon #Medicaid #AlabamaMedicaid #Healthcare #MedicaidRenewal #PublicHealth

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Preferred Drug List (PDL) and Pharmacy Quarterly Update [Medicaid] Effective October 1, 2023, the Alabama Medicaid Agency will: 1. Continue to monitor the stimulant shortage affecting ADHD medications. Should you need assistance, please contact Kepro at the number below for alternative prescribing and dispensing options. 2. Update the PDL to reflect the quarterly updates listed below:

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #ADHD #PharmacyUpdates #MedicaidNews #Healthcare

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Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease [Medicaid] Effective November 1, 2023, the Alabama Medicaid Agency will implement hard edits on cumulative daily MME claims exceeding 150 MME/day. A phase-in period for claims exceeding 120 MME/day, but less than 150 MME/day, will also be implemented.

AL. State Agencies:Alabama News Beacon #OpioidCrisis #MME #AlabamaMedicaid #PrescriptionDrugAbuse #PublicHealth

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Provider Enrollment – Durable Medical Equipment Revalidation [Medicaid] Effective September 1, 2023, Alabama Medicaid will change the revalidation for all Durable Medical Equipment (DME) providers from annually to every three years. If providers do not revalidate, their enrollment will be closed.

AL. State Agencies:Alabama News Beacon #ProviderEnrollment #DurableMedicalEquipment #Medicaid #Healthcare #AlabamaMedicaid

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Public Comment Sought for the Alabama Medicaid Agency’s Quality Strategy for the Alabama Coordinated Health Network (ACHN) [Medicaid] The Alabama Medicaid Agency is seeking public comment on its proposed ACHN Quality Strategy.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #HealthCare #PublicHealth #Medicaid #HealthStrategy

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Changes to Prior Authorization (PA) Requirement for Inpatient and Outpatient Dental Services [Medicaid] Beginning April 1, 2023, Alabama Medicaid no longer requires PA for the dental procedure codes listed below when provided in an inpatient or outpatient hospital setting (place of service 19, 21, or 22) to recipients ages 5 and older.

AL. State Agencies:Alabama News Beacon #DentalCare #Medicaid #HealthPolicy #PriorAuthorization #AlabamaMedicaid

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Specialist Referrals Not Required by Alabama Medicaid [Medicaid] On June 1, 2023, Alabama Medicaid resumed the EPSDT referral requirement for EPSDT visits. Once a child has an EPSDT screening, all subsequent visits to other providers for further diagnosis or treatment must have a written referral (Form 362) from the EPSDT screening provider.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #EPSDT #Healthcare #ChildHealth #MedicaidReform

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Alabama Medicaid Recipients to Receive Notifications from the Agency [Medicaid] When it’s time to renew, you should expect a recorded call, text message, and an email from Alabama Medicaid.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #MedicaidRenewal #HealthCare #MedicaidAlerts #HealthInsurance

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Reminder of Patient-Centered Medical Home (PCMH) Recognition Attestation Deadline [Medicaid] The Alabama Medicaid Agency would like to remind Alabama Coordinated Health Network (ACHN) Primary Care Physician (PCP) groups of the following deadline:

AL. State Agencies:Alabama News Beacon #PatientCenteredCare #PCMH #AlabamaMedicaid #PrimaryCare #Healthcare

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Alabama Medicaid Seeks Public Comments on Home and Community-Based Waivers [Medicaid] The Alabama Medicaid Agency (Medicaid) is seeking public comments on the proposed amendments to the Alabama Home and Community Based Services (HCBS), Intellectual Disabilities (ID) Waiver and the Living at Home (LAH) Waiver for persons with Intellectual Disabilities.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #HomeAndCommunityBasedServices #IntellectualDisabilities #PublicComments #Healthcare

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Preferred Drug List (PDL) and Pharmacy Quarterly Update [Medicaid] Alabama Medicaid Agency Preferred Drug List (PDL) and Pharmacy Quarterly Update will be effective July 1, 2023.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #PreferredDrugList #PharmacyUpdate #MedicaidNews #HealthcareAccess

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Alabama Medicaid to hold Community Waiver Program (CWP) Public Forum, May 3, 2023 [Medicaid] The Alabama Medicaid Agency invites providers, recipients, advocates, and other interested individuals to provide input during a public forum on the progress of the Community Waiver Program (CWP).

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #CommunityWaiverProgram #PublicForum #Medicaid #Healthcare

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Public Forum set on Alabama Medicaid Plan First Section 1115 Demonstration Waiver Progress [Medicaid] Providers, recipients, and other interested individuals are invited to provide comments on the progress of the Alabama Medicaid Plan First Section 1115 Demonstration Waiver during a virtual public forum on May 3, 2023.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #MedicaidWaiver #HealthcareForAll #PublicForum #Medicaid

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Maternity Dental Benefit Coverage [Medicaid] The Alabama Medicaid Agency received approval to provide dental services to eligible pregnant recipients as of October 1, 2022.

AL. State Agencies:Alabama News Beacon #MaternityBenefits #DentalCoverage #Medicaid #PregnancyHealth #AlabamaMedicaid

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Changes to Hepatitis C Prior Authorization (PA) Criteria [Medicaid] Effective October 1, 2022, the Alabama Medicaid Agency removed the requirement of absence of alcohol and illicit drug use by recipients for the prior approval of antiviral drugs used in the treatment of hepatitis C.

AL. State Agencies:Alabama News Beacon #HepatitisC #Medicaid #AlabamaMedicaid #AntiviralDrugs #PublicHealth

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Update to ostomy supply coverage policy [Medicaid] Effective for dates of service on or after April 1, 2023, Alabama Medicaid Agency will cover the below ostomy supply procedure codes. The procedure codes listed below will be subject to maximum allowed units per year. Refer to the DME Fee Schedule on Medicaid’s website for reimbursement rates and benefit limits for covered equipment and supplies: http://medicaid.alabama.gov/content/Gated/7.3G_Fee_Schedules.aspx.

AL. State Agencies:Alabama News Beacon #OstomyCare #Medicaid #Healthcare #AlabamaMedicaid #PatientSupport

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Changes to Hepatitis C Prior Authorization (PA) Criteria [Medicaid] Effective October 1, 2022, the Alabama Medicaid Agency removed the requirement of absence of alcohol and illicit drug use by recipients for the prior approval of antiviral drugs used in the treatment of hepatitis C.

AL. State Agencies:Alabama News Beacon #HepatitisC #Medicaid #HealthCare #AlabamaMedicaid #AntiviralDrugs

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COVID-19 Emergency Expiration Date Extended to March 31, 2023 [Medicaid] All previously published expiration dates related to the COVID-19 public health emergency (PHE) are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of March 31, 2023, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.

AL. State Agencies:Alabama News Beacon #COVID19 #PublicHealth #AlabamaMedicaid #Healthcare #EmergencyDeclaration

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Alabama Medicaid Seeks Public Comment on Home and Community-Based Settings Final Rule [Medicaid] Alabama Medicaid Seeks Public Comment on Home and Community-Based Settings Final Rule

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #PublicComment #CommunityBasedCare #HomeCare #MedicaidReform

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Alabama Medicaid announces 1095-B Form Process [Medicaid] Again, this year, Alabama Medicaid will not be mailing a 1095-B form to recipients. Due to a change in law about three years ago, most Medicaid recipients do not need proof of Medicaid coverage to file their taxes.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #MedicaidCoverage #TaxSeason #1095BForm #HealthCare

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Medicaid System Education and Training Survey Request [Medicaid] The Alabama Medicaid Agency (Medicaid) is surveying providers enrolled in Medicaid to understand their learning experience with education and training on Medicaid System (Web Portal, Provider Electronic Solutions (PES) Software, and Long Term Care Admission (LTC) Notification software).

AL. State Agencies:Alabama News Beacon #Medicaid #HealthcareTraining #AlabamaMedicaid #ProviderEducation #HealthcareProviders

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COVID-19 Emergency Expiration Date Extended to January 31, 2023, and Preparation for the End of the Public Health Emergency [Medicaid] All previously published expiration dates related to the COVID-19 public health emergency (PHE) are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of January 31, 2023, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.

AL. State Agencies:Alabama News Beacon #COVID19 #PublicHealth #EmergencyPreparedness #AlabamaMedicaid #HealthCare

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Preferred Drug List (PDL) and Pharmacy Quarterly Update [Medicaid] Effective January 1, 2023, the Alabama Medicaid Agency will require Pradaxa to be billed with a Dispense as Written (DAW) Code of 9 and require Prior Authorization (PA) for Dabigatran (generic Pradaxa). Brand Pradaxa will remain as preferred.

AL. State Agencies:Alabama News Beacon #AlabamaMedicaid #Pradaxa #Dabigatran #PharmacyUpdate #MedicationManagement

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COVID-19 Emergency Expiration Date Extended to December 31, 2022, and Preparation for the End of the Public Health Emergency [Medicaid] All previously published expiration dates related to the COVID-19 public health emergency (PHE) are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of December 31, 2022, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.

AL. State Agencies:Alabama News Beacon #COVID19 #PublicHealthEmergency #AlabamaMedicaid #HealthCare #Medicaid

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