Alabama Media Portal 2.0 - Press Releases

TO: Participating Alabama Coordinated Health Network Primary Care Physician Group

RE: Fiscal Year (FY) 2025 (October 1, 2024-September 30, 2025) Patient-Centered Medical Home (PCMH) Attestations

Alabama Medicaid Primary Care Physician (PCP) Groups actively participating with an Alabama Coordinated Health Network (ACHN) may be eligible to receive a quarterly Patient-Centered Medical Home (PCMH) Bonus Payment. The PCMH Bonus will be based on actual achievement of or progress towards achievement of PCMH Certification through a nationally recognized entity such as the National Committee for Quality Assurance (NCQA), the Joint Commission, or the Compliance Team, among others. Attestation for this certification must be received annually by the Agency no later than October 1st to ensure eligibility for the PCMH Bonus for the upcoming fiscal year.

Note: The PCMH Bonus is optional. PCP Groups may still be eligible to receive the quality and cost effectiveness bonus payments if they chose not to participate in the PCMH attestation process.

Below is the Alabama Medicaid Agency’s PCMH bonus attestation process:

1. PCMH Bonus payments are paid ONLY to PCP Groups who have achieved or working towards achieving PCMH certification from a nationally recognized certifying entity (e.g., NCQA, the Joint Commission, the Compliance Team, etc.).

2. ALL PCP Groups interested in receiving the PCMH Bonus payment must attest to the Agency. This includes PCP Groups who have achieved or made progress towards PCMH Certification through NCQA.

3. Attestation must be received annually by the Agency no later than October 1^st. The attestation will be valid for one year.

4. PCP Groups can begin submitting their attestation for FY 2025 now.

PCP Groups that have not received PCMH Recognition but have made adequate progress towards PCMH Recognition may be eligible to receive the PCMH Bonus. PCP Groups that have made adequate progress must complete and submit the PCMH Attestation Form and supporting documentation showing adequate progress with their certifying entity. Refer to Chapter 40, of the most current version of the Alabama Medicaid Provider Manual for definitions of adequate progress for each certifying entity.

You may access the Provider Manual with the following link: https://medicaid.alabama.gov/content/Gated/7.6.1G_Provider_Manuals.aspx.

To be eligible for the PCMH Bonus, PCP Groups should adhere to the following protocol:

                 1.     Obtain PCMH Recognition or make adequate progress. PCMH Recognition is a separate
                 process from attestation. PCP Groups must contact the national certifying entity from which
                 they wish to receive recognition and make progress or complete the PCMH certification process.

                 The Agency cannot assist with the PCMH Certification process nor recommend a certifying
                 entity to PCP groups.

Note: It is imperative that PCP Groups begin the PCMH certification process with their certifying entity as soon as possible to avoid tardy attestation to the Medicaid Agency. The Agency will not accept attestations after the October 1^st deadline.

2. Attest to the Medicaid Agency. After receiving PCMH certification or making adequate progress from the national certifying entity, the PCP Group must attest (via PCMH Attestation Form) to the Agency no later than October 1^st to receive PCMH Bonus eligibility for the upcoming fiscal year (e.g., to receive PCMH Bonus eligibility for FY2025, the attestation form and supporting documentation must be received by October 1,2024). The Agency will not accept attestations after the October 1^st deadline.

4. Remember to attest every year. PCP Groups that wish to continue to receive the
PCMH bonus must attest annually no later than October 1^st.

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