Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-7 - HOSPITALS
Section 560-X-7-.02 - Participation
Current through Register Vol. 42, No. 11, August 30, 2024
(1) Eligibility. In order to participate in the Title XIX Medicaid program and to receive Medicaid payment for inpatient and outpatient hospital services, a hospital provider must meet the following requirements:
(2) Enrollment. Hospitals should refer to the Alabama Medicaid Provider Manual (Becoming a Medicaid Provider - Chapter 2) for complete enrollment instructions.
(3) Participating out-of-state (border) hospitals are subject to all program regulations and procedures that apply to participating Alabama hospitals and shall submit copies of their annual certification from CMS, State licensing authority, and other changes regarding certification. "Border" is defined as within 30 miles of the Alabama state line.
(4) Nonparticipating hospitals are those hospitals which have not executed an agreement with Alabama Medicaid covering their program participation, but provide medically necessary covered out-of-state services.
(5) The Fiscal Agent will be responsible for enrolling any Title XVIII (Medicare) certified hospital that wishes to enroll as a Qualified Medicare Beneficiary (QMB-only) provider.
Author: Solomon Williams, Associate Director, Institutional Services
Statutory Authority: State Plan, §§2.7, 4.11, 4.13, Attachment 7.2A; Title XIX Social Security Act; 42 C.F.R. §§ 405.191, 431.51, 431.52, 431.107, 440.10, 440.20; Medicare Catastrophic Coverage Act of 1988 ( Public Law 100-360).