Ala. Admin. Code r. 560-X-64-.16

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-64-.16 - ICN Covered Population

(1) The following groups of eligible Medicaid beneficiaries shall be included for coverage by an integrated care network (ICN):

(a) Individuals that meet the current admission criteria for nursing facility care as described in Alabama Medicaid Administrative Code Rule 560-X-10-.10 and who are receiving nursing facility services in accordance with Alabama Medicaid Administrative Code Rule 560-X-10-.04(1);

(b) Individuals that meet the eligibility criteria for the Home and Community-Based Services for the Alabama Community Transition (ACT) Waiver in accordance with Alabama Medicaid Administrative Code Rule 560-X-44-.02; and

(c) Individuals that meet the eligibility criteria for the Home and Community-Based Services for the Elderly and Disabled Waiver in accordance with Alabama Medicaid Administrative Code Rule 560-X-36-.02.

(2) All groups of Medicaid beneficiaries not expressly included in (1) above will continue to be served by the Medicaid fee-for-service program outside of the ICN.

Ala. Admin. Code r. 560-X-64-.16

Amended by Alabama Administrative Monthly Volume XXXVI, Issue No. 01, October 31, 2017, eff. 11/28/2017.

Amended by Alabama Administrative Monthly Volume XXXVI, Issue No. 09, June 29, 2018, eff. 7/26/2018.

Author: Stephanie Lindsay, Administrator, Administrative Procedures Office

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. Part 438.