July 20, 2015

State of Alabama
Press Release: Medicaid

Care Coordination Services and Access to Patients in Hospitals and Provider Offices

     PDF Version

    TO:  All Providers and Hospitals

Effective immediately, all Medicaid-enrolled providers, hospitals and other facilities must allow individuals providing care coordination services who are employees of or contracted with any Probationary RCO or Health Home access to their patients receiving care in the providers’ and hospitals’ facilities. Restricting, impeding or interfering with Medicaid recipient access to medically necessary or care coordination services is strictly prohibited and may result in sanctions against the entities involved.

 

Specifically:

 

·                Providers must not restrict, impede, or interfere with the delivery of services or care coordination benefits for any Medicaid recipient whether or not the Provider is providing such care.

 

·                Hospitals and other facilities must not restrict, impede or interfere with the delivery of services or care coordination benefits for any Medicaid recipient, including services or benefits that may be provided by a Provider or individual providing care coordination services that is out of network, unaffiliated, or external to the facility or hospital the Medicaid recipient is currently admitted to or seeking care from.

 

·                Hospitals must also not restrict or otherwise hinder such Medicaid recipients’ access to Care Coordinators or the delivery of care coordination services by an unaffiliated Probationary RCO or Health Home through the use of written and/or oral communications to recipients in the hospital about the availability of, access to or quality of care coordination services offered by an affiliated Probationary RCO or Health Home.

 

Questions or comments should be directed to Carolyn Miller, Associate Director, Project Development and Quality Improvement, via e-mail at Carolyn.miller@medicaid.alabama.gov or phone at 334-353-5539.

 

 

 

 



  • For more information, visit http://medicaid.alabama.gov
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