Alabama Medicaid: The Move To A Managed Care Program (Part II)


This is Part II of a two-part series on the new Medicaid structure in Alabama. Part I of the series, which was published last month, discussed organizational and operational requirements of RCOs. This Part II will discuss the antitrust immunity provided to third-party payers, health care providers and other individuals and corporations to collectively cooperate, negotiate and agree on price and health care delivery.

Earlier this year Governor Bentley signed into law Act 2013-261, Ala. Code § 22-6-150 et seq. (SB 340), drafted by Senator Greg Reed (R-Jasper), which completely restructures the Alabama Medicaid program (the "Act"). Under the Act, Medicaid services will be delivered on a managed care basis through five (5) risk-bearing regional care organizations ("RCOs") which will be paid on a capitated basis. The new Medicaid structure is expected to be fully implemented and operational by October 1, 2016.

Originally Published in the Birmingham Medical News - February 10, 2014.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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