Birmingham Medical News : Alabama Medicaid: Changes to the Regional Care Organization Statute

Articles / Publications

On May 17, 2013, Governor Bentley signed into law Act 2013-261, Ala. Code § 22-6-150 et. seq. As you may recall, the new law changed the Alabama Medicaid program from a fee-for-service program to a managed care program and created Regional Care Organizations ("RCOs") to serve as the conduit for care to Medicaid beneficiaries. In the last legislative session, the Alabama legislature passed amendments to the RCO statute. These changes impacted the way in which RCOs are structured and provide for a grievance procedure for providers who are dissatisfied with the contracts or terms offered by a RCO.

The original RCO statute provided for a RCO board of directors (the "Board") consisting of 12 members representing the risk-bearing participants, 8 non risk-bearing participants and 3 community representatives totaling 23 members. Under the new law, the 3 community representatives are no longer an additional category but are now included as part of the 8 non risk-bearing representatives. Consequently, the 8 non risk-bearing participants consist of 5 medical professionals and 3 community representatives. Of the 5 medical professionals, 2 are primary care physicians appointed by the Medical Association of the State of Alabama ("MASA") as opposed to the caucus of county boards of health. These 2 physicians will serve with 1 physician representing a Federally Qualified Health Care Center, an optometrist and a pharmacist. Therefore, the composition of the Board will be as follows:

To download the full article, please click here.

Related Professionals

Jump to Page
Arrow icon Top

Contact Us

We use cookies to improve your website experience, provide additional security, and remember you when you return to the website. This website does not respond to "Do Not Track" signals. By clicking "Accept," you agree to our use of cookies. To learn more about how we use cookies, please see our Privacy Policy.

Necessary Cookies

Necessary cookies enable core functionality such as security, network management, and accessibility. These cookies may only be disabled by changing your browser settings, but this may affect how the website functions.

Analytical Cookies

Analytical cookies help us improve our website by collecting and reporting information on its usage. We access and process information from these cookies at an aggregate level.