September 23, 2015

State of Alabama
Press Release: Medicaid

Contracts, rate development & data dominate RCO meeting discussions

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Representatives of the state’s 11 probationary Regional Care Organizations met in Montgomery September 22 to review the final version of a draft contract to be submitted to the Centers for Medicare and Medicaid Services in early October and to receive updated information on various issues related to RCO implementation, including provider standards committee formation, encounter data and capitation rates.

The updated version of the draft contract reflects the input of the probationary RCOs and multiple stakeholder groups which submitted over 1100 comments on a previous version of the contract that was released in December 2014. Comments generally focused on finance, health IT, enrollment, encounters and legal issues. The updated draft contract is also written with the expectation that CMS will require the Agency to maintain freedom of choice with the participation of at least two organizations in each region.

Medicaid Commissioner Stephanie Azar told the group that after a short comment period, the Agency will submit the document to CMS for approval. Federal approval of the contract is required before final RCO certification can take place. She also reported that the Agency’s representatives are talking weekly with CMS regarding the state’s waiver application.

Azar emphasized that with the recent approval of the state’s General Fund budget for FY 2016, Governor Robert Bentley is now working on a plan to fund Medicaid reform.

“The governor is supporting us in getting the money we need to move forward with our transformation plans,” she said.


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