Alabama Medicaid Agency

The meeting commenced after confirming a quorum and the absence of conflicts of interest. Key discussions involved an overview of the MAC's purpose, operations, and guidelines. Updates from the Alabama Medicaid Agency covered the organizational chart, Presumptive Eligibility for Pregnancy (PEP), recent changes to the hysterectomy coverage rule, the EPDST Desk Review, and modifications to the non-pharmacy prior authorization process. Furthermore, information regarding TMaH and Health Services for Justice-Involved Youth was presented. Member inquiries focused on potential changes to 12-month eligibility for children related to the Big Beautiful Bill (which Alabama is not mandated to implement), retroactive coverage for children (potentially changing to the month of application plus the prior two months), and waiver eligibility for teenagers with special needs turning 19. Action items included members completing a survey and a Conflict of Interest Disclosure Form, and indicating interest in MAC officer roles.

The meeting commenced with confirmation of a quorum and no disclosed conflicts of interest. Medicaid leadership, including the Commissioner, Deputy Commissioners, and Chief Business Officer, introduced themselves and explained the program areas and responsibilities they oversee. A presentation covered the background, outcomes, reporting information, purpose, operations, meeting structure, and topics pertaining to the Beneficiary Advisory Council (BAC). Member roles, responsibilities, and guidelines were also presented. Action items for BAC members included completing the Identification Preference Form, Conflict of Interest Form, and a survey. The Agency indicated it would determine the date for the February meeting based on survey results.

The document outlines the mission, vision, and values aimed at promoting quality and innovative healthcare accessibility for all Alabamians through efficient financing and key leadership. The core values emphasize respect, integrity, excellence, teamwork, and innovation to effectively meet the changing healthcare environment.

The Alabama Medicaid Agency's Health Information Technology Plan (SMHP) outlines the state's efforts to promote interoperability and the meaningful use of electronic health records (EHRs) among its providers. Key areas of focus include transitioning to managed health care delivery, value-based purchasing, and leveraging clinical quality metrics for population health analytics. The plan details the implementation of One Health Record®, Alabama's Health Information Exchange (HIE), to enhance communication between providers and patients, improve care coordination, and support public health reporting. It also addresses the administration and oversight of the EHR Incentive Payment Program, including provider eligibility verification, payment processes, and audit strategies. The plan emphasizes the importance of stakeholder engagement and collaboration to achieve its goals.

The Alabama Money Follows the Person Rebalancing Demonstration Operational Protocol outlines the state's plan to transition individuals from institutional settings to community living. The plan focuses on rebalancing the long-term support delivery system, addressing gaps in services, and enhancing infrastructure to support transitions. Key areas of focus include participant recruitment and enrollment, informed consent procedures, outreach and marketing strategies, stakeholder involvement, and the provision of benefits and services. The plan also emphasizes consumer supports, self-direction opportunities, quality assurance measures, housing initiatives, and continuity of care post-demonstration to ensure effective outcomes and sustainable community living for participants.