Current through Register Vol. 43, No. 02, November 27, 2024
(1) In order to
participate in the Title XIX Medicaid program and to receive Medicaid payment
for inpatient services for individuals 65 and older, a provider must meet the
following requirements:
(a) Be certified for
participation in the Medicare/Medicaid program;
(b) Be licensed as an Alabama free-standing
acute geriatric psychiatric hospital in accordance with current rules contained
in the Alabama Administrative Code Chapter 420-5-7. State hospitals that do not
require licensing as per state law are exempt from this provision (Alabama
Code, Section
22-50-1, et seq.);
(c) Be accredited by the Joint Commission on
Accreditation of Healthcare Organizations;
(d) Specialize in the care and treatment of
geriatric patients with serious mental illness;
(e) Have on staff at least one full-time
board certified geriatric psychiatrist/geriatrician; or a full-time board
certified adult psychiatrist with a minimum of 3 years' experience caring for
geriatric patients 65 or older.
(f)
Employ only staff who meet training/certification standards in the area of
adult psychiatry as defined by the State's mental health authority;
(g) Be recognized as a teaching hospital, and
affiliated with at least one four-year institution of higher education with a
multi-disciplinary approach to the care and treatment of geriatric patients
with serious mental illness;
(h)
Provide out-patient and community liaison services throughout the State of
Alabama directly or through contract with qualified providers;
(i) Be in compliance with Title VI and VII of
the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973,
the Age Discrimination Act of 1975, and the Americans with Disabilities
Act;
(j) Execute an Alabama
Medicaid Provider Agreement for participation in the Medicaid
program;
(k) Submit a written
description of an acceptable utilization review plan currently in effect;
(l) Submit a budget of cost for its
inpatient services for its initial cost reporting period, if a new provider;
and
(m) Be under the jurisdiction
of the State's mental health authority.
(2) Application by Alabama geriatric
psychiatric facilities for participation in the Medicaid program shall be made
to the appropriate address indicated in the Provider Manual.
(3) It is the facility's responsibility to
ensure compliance with all federal and state regulations and to ensure that all
required documentation is included in the recipient's record. Failure to comply
will result in denial of payment and possible recoupment of reimbursements made
previously.