Alerts

PCP Groups Required to Complete New Enrollment Agreement
Apr 5, 2019  -  The ACHN anticipated start date is October 1, 2019. Primary Care Physicians (PCPs) who want to receive bonus and participation payments without delay in conjunction with the state’s planned ACHN program must sign a new enrollment agreement with Medicaid by July 1, 2019.
Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit
Mar 27, 2019  -  Effective May 1, 2019 the Alabama Medicaid Agency will begin implementing cumulative daily MME edits for opioid experienced recipients. Higher doses of opioids are associated with higher risk of overdose and death - even relatively low dosages (20-50 MME per day) may increase risk.1 Therefore, Alabama Medicaid will limit the amount of cumulative MME allowed per day on opioid claims. The edit will begin at 250 cumulative MME per day and will gradually decrease over time. The final cumulative MME target is scheduled to be 90 MME per day. This edit is different, and in addition to, the short-acting opioid naïve edit implemented on November 1, 2018.
Preferred Drug List (PDL) Quarterly Update
Mar 12, 2019  -  Effective April 1, 2019 the Alabama Medicaid Agency will: 1. Require Prior Authorization (PA) for generic tobramycin/dexamethasone ophthalmic drops, generic albuterol HFA, and generic fluticasone/salmeterol inhalation device. Brand Tobradex and Advair Diskus will be added as preferred. Brand Proair HFA and Proventil HFA will remain preferred.
Professional Claim Reimbursement for Hepatitis A Vaccine
Feb 10, 2019  -  In response to the hepatitis A outbreak identified by the Alabama Department of Public Health, Alabama Medicaid has started covering the hepatitis A vaccine for recipients ages 19 and older. Procedure code 90632 should be billed. Please refer to Provider Billing Manual Chapter 28 – Physicians and Appendix H – Physician Administered Drugs for details about vaccine billing.

Recent Alerts


Date 
Apr 5, 2019 PCP Groups Required to Complete New Enrollment Agreement
Mar 27, 2019 Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit
Mar 12, 2019 Preferred Drug List (PDL) Quarterly Update
Feb 10, 2019 Professional Claim Reimbursement for Hepatitis A Vaccine
Jan 29, 2019 Reimbursement for Administration of Hepatitis A Vaccine
Jan 28, 2019 Regional Meetings to Discuss ACHN plans with Primary Care Providers
Jan 16, 2019 LTC Admission Software Upgrade
Dec 26, 2018 2019 CPT Code Changes for Behavioral Health Providers
Dec 3, 2018 Federal Rule Change for Prenatal Claims
Dec 3, 2018 Preferred Drug List (PDL) Quarterly Update
Nov 6, 2018 Opioid Refill Threshold Increase
Sep 25, 2018 Individual AMHP Enrollment Requirements
Sep 25, 2018 Short-Acting Opioid Naïve Limits
Sep 4, 2018 Preferred Drug List (PDL) Quarterly Update
Aug 21, 2018 Synagis® Criteria for 2018 – 2019 Season
12345678910...