Alabama Administrative Code

Deductible and/or Co-insurance will be reimbursed up to the full amount of the Medicaid encounter rate. Author: Carol Akin, Associate Director, Clinic/Ancillary Services Notes Ala. Admin. Code r. 560-X-8-.05 Rule effective October 1, 1982. Amended: effective October 13, 1987. Rep…

(1) Medicaid and Medicare/Medicaid related recipients are required to pay and independent rural health clinics are required to collect the established copayment amount for each clinic encounter. (2) The cost-sharing requirement does not apply to services provided for the followin…

(1) A provider agrees to accept as payment in full the amount paid by the State, plus any copayment amount required to be paid by the recipients, for covered items and further agrees to make no additional charge or charges for covered items to the recipient. (2) A provider may bi…

The Alabama Medicaid Agency will pay for services provided by independent laboratories that are enrolled by contract under the following conditions: (1) The services must be medically necessary. (2) The patient must be eligible for Medicaid at the time the services are rendered. …

Laboratory Services are professional and technical laboratory services - (a) ordered and provided by or under the direction of a physician or other licensed practitioner of the healing arts within the scope of his practice as defined by state law; (b) ordered by a physician but p…

(1) Independent laboratories must meet the following requirements for participation in the Alabama Medicaid program: (a) Be certified for participation with Medicare. (b) Have a valid CLIA certification (i.e., clinical labs). (c) Have a Physician's supervisory Certification and u…

Author: Debra Moore Notes Ala. Admin. Code r. 560-X-9-.04 Rule effective October 1, 1982. Emergency rule effective October 15, 1990. Amended effective January 15, 1991; effective June 14, 1993. Repealed: Filed September 8, 1998; effective October 13, 1998. Statutory Authority: St…

Author: Debra Moore Notes Ala. Admin. Code r. 560-X-9-.05 Rule effective October 1, 1982. Amended effective March 11, 1985. Emergency rule effective October 15, 1990. Amended effective January 15, 1991. Repealed: Filed September 8, 1998; effective October 13, 1998. Statutory Auth…

(1) For time limits on claims submission refer to the Medicaid Provider Manual, Independent Laboratory chapter. (2) Claims for lab services must contain a valid diagnosis code. (3) Claims submitted must contain the provider number of the lab that actually performed the services. …

Authors: Sheila G. Dunbar, Debra Moore Notes Ala. Admin. Code r. 560-X-9-.07 Rule effective October 1, 1982. Amended effective December 6, 1984. Emergency Rule effective October 15, 1990. Amended: effective January 15, 1991. Amended: Filed September 8, 1998; effective October 11,…

For guidelines on submitting claims to Medicaid when a third party is involved, refer to the Medicaid Provider Manual, Independent Laboratory chapter. Author: Lynn Sharp, Associate Director, Policy Development Unit Notes Ala. Admin. Code r. 560-X-9-.08 Ed. Note: Previous rule "Di…

(1) Providers should not send recipients bills or statements for covered services once the recipient has been accepted as a Medicaid patient. (2) Providers may send a notice to the recipient stating their claim is still outstanding if the notice indicates in bold letters, "THIS I…

Notes Ala. Admin. Code r. 560-X-9-.10 Rule effective October 1, 1982. Amended effective March 12, 1984; June 8, 1984; January 8, 1985. Emergency rule effective January 14, 1985. Amended effective April 11, 1985; May 8, 1985; November 11, 1985. Emergency rule effective October 15,…

Notes Ala. Admin. Code r. 560-X-9-.11 Previous rule "Claims Processing" effective October 1, 1982. Emergency repeal effective October 15, 1990. Permanent repeal effective January 15, 1991.

(1) Medicaid will not pay packing and handling charges for referred laboratory services. Payment for referred tests will be made to the referred laboratory only at the normal rate. This policy shall be monitored through postpayment review by Medicaid. (2) Medicaid will not pay fo…

The Department of Mental Health and Mental Retardation is a department of state government as provided by Code of Ala. 1975, § 22-50-2, and is composed of the state mental health and mental retardation commissioner and such divisions and administrative sections as the mental heal…

The term rule is defined to be any rule, policy, regulation or order establishing standards for the admission, diagnosis, care and treatment of persons receiving mental health or mental retardation services. Author: Division of Mental Retardation, DMR/MR Notes Ala. Admin. Code r.…

(1) Patients. Those persons afflicted with mental or emotional illness and residing in a state operated hospital or residential facilities operated by the Mental Illness Division. (2) Residents. Individuals residing in a 24 hour-a-day residential facility, who are afflicted with …

(1) The Mental Health and Mental Retardation Commissioner is the agency head of the department. (2) On May 1, 1984, a bill was signed into law which renamed the Department of Mental Health to the Department of Mental Health and Mental Retardation. Additional provisions of the new…

The governor and the commissioner of mental health and mental retardation are constituted by law as a public corporation to be known as the Department of Mental Health and Mental Retardation. Author: Division of Mental Retardation, DMH/MR Notes Ala. Admin. Code r. 580-1-1-.05 Fil…

The authority of the department, and its commissioner, is set forth in Code of Ala. 1975, § 22-50-9 and § 22-50-11 and includes but is not limited to the following: (1) The Department of Mental Health and Mental Retardation through its commissioner is hereby authorized to act in …

The State Department of Mental Health and Mental Retardation operates under the provisions set forth in the Code of Ala. 1975, Title 22, Chapter 50. Author: Division of Mental Retardation, DMH/MR Notes Ala. Admin. Code r. 580-1-1-.07 Filed September 5, 1984. Repealed and Replaced…

Department of Mental Health and Mental Retardation is under the direction, supervision, and the control of the Commissioner, who is appointed by the Governor. (1) The structural organization within the Department of Mental Health and Mental Retardation complies with the Code of A…

(1) The central office of the Alabama Department of Mental Health and Mental Retardation is located at 100 N. Union Street, Montgomery, AL 36130-1410. Author: Division of Mental Retardation, DMR/MR Notes Ala. Admin. Code r. 580-1-1-.09 Filed September 5, 1984. Repealed and Replac…

(1) Any form or publication used by the Department of Mental Health and Mental Retardation during the course of its operation and dealings with the public may be obtained by contacting the office of the Commissioner of Mental Health, 100 N. Union Street, Montgomery, AL 36130-1410…

(1) Public information within the State Mental Health and Mental Retardation Department is designed to provide information for the general public and designed to work closely with advocacy and consumer groups and other concerned citizens where support is vital in fostering mental…

The rulemaking proceedings of the Department of Mental Health and Mental Retardation shall be carried out in the manner prescribed by law in the Code of Ala. 1975, § 22-50-11(8) which states that "The mental health and mental retardation department is hereby authorized and direct…

The Department of Mental Health and Mental Retardation shall follow the rules of procedure for filing, consideration, and disposition of declaratory rulings under the provisions of the Code of Ala. 1975, Title 4, Chapter 22, in accordance with the rules published in the Alabama A…

The manner in which proceedings in contested cases will be conducted by the Department of Mental Health shall be in accordance with the provisions of the Code of Ala. 1975, Title 4, Chapter 22, and the rules published in the Alabama Administrative Code. Author: Division of Mental…

(1) Any interested person may petition the Department requesting the adoption, amendment or repeal of a rule. The petition shall be in writing and shall include:(a) The name and address of the petitioner. (b) An exact statement of the proposed rule or amendment or identification …

No person, partnership, corporation, or association of persons shall operate a facility or institution for the care or treatment of any kind of mental or emotional illness or service to the mentally retarded as defined in Code of Ala. 1975, without being certified by the departme…

(1) A staff member of the Department of Mental Health and Mental Retardation, located at 100 N. Union Street, Montgomery, AL 36130-1410 will serve as the Department Secretary. (2) The duties of the Department Secretary include the following: (a) File certified copies of all rules…

The Department will on an annual basis establish reasonable fees for services made available to the public and shall collect such fees unless, upon investigation it is determined that the person receiving such services is unable to pay the established fee, and in such case such a…

(1) Sections 22-50-1, et seq. and 22-51-1., et seq., Code of Ala. 1975, established the Alabama Department of Mental Health and Mental Retardation, and the Regional Mental Health Boards, respectively, as the recognized public entities responsible for administering state appropria…

Reserved Notes Ala. Admin. Code r. 580-1-1-.20

The mission of the Alabama Department of Mental Health and Mental Retardation (DMH/MR) under the Code of Ala. 1975, Sections 22-50-1 through 91, Act 881, is to act in "any prudent way to provide mental health services and mental retardation services for the people of Alabama". Th…

(1) A Comprehensive 310 Board must have authority through its Articles of Incorporation to directly provide: planning, studies, and services, for mental illness, mental retardation, and substance abuse populations, for all counties for which they are incorporated. A Comprehensive…

(1) A certified 310 Board must be under contract with DMH/MR for services provided. (2) The DMH/MR shall certify no more that one (1) Comprehensive 310 and/or one Specialty 310 in a county for each of the specified service populations (Mental Illness, Mental Retardation and Subst…

(1) The Department of Mental Health and Mental Retardation (DMH/MR) by November 1, 2001 shall identify the current array of 310 Boards as Comprehensive or Specialty by county. (2) As of December 1, 2001, DMH/MR shall grandfather all currently existing 310 Boards as identified wit…

(1) The certified Comprehensive 310 Board, in conjunction with the DMH/MR, must plan and take steps which lead to comprehensive state and community action to combat all forms of mental or emotional illness or debility, including but not limited to, alcoholism, drug addiction, epi…

(1) A certified 310 Board must meet the following standards: (a) The 310 Board must have on file with DMH/MR their Articles of Incorporation and all amendments, which were provided to the local county governmental entity which established and approved the articles or amendments. …

(1) Providers, not otherwise covered by 580-1-2, may contract directly with DMH/MR for one or more of the following programs or services:(a) Inpatient (b) Outpatient/Therapy Services (c) Partial Hospitalization (d) Emergency Care (e) Community Education and Consultation (f) Diagn…

The mission of the Alabama Department of Mental Health and Mental Retardation (DMH/MR) under the Code of Ala. 1975, Sections 22-50-1 through 91, Act 881, is to act in "any prudent way to provide mental health services and mental retardation services for the people of Alabama". Th…

Providers, not otherwise covered by 580-2-1, may contract directly with DMH/MR for one or more of the following programs or services: (a) Inpatient (b) Outpatient/Therapy Services (c) Partial Hospitalization (d) Emergency Care (e) Community Education and Consultation (f) Diagnosi…

For specific programs and services, whether contracted or subcontracted, provided by Providers, Providers shall meet and insure compliance with the specified DMH/MR service division's certification standards. Author: Department of Mental Health and Mental Retardation Notes Ala. A…

(1) Providers will develop and provide services within resource availability. (2) DMH/MR shall maintain authority for confirmation, enrollment, and establishment of eligibility for individuals for services under contract with DMH/MR. Author: Department of Mental Health and Mental…

Providers must meet the following standards: (1) Providers must supply to the DMH/MR annually an unqualified prior year audit including such DMH/MR contracted funds allocated for subcontractors. (2) Providers when subcontracting shall provide to the DMH/MR a copy of the subcontra…

Governing Authority (Repealed) Notes Ala. Admin. Code r. 580-2-10-.01

Notes Ala. Admin. Code r. 580-2-10-.02 Original rule filed September 30, 1982. Revised: Filed August 3, 1984. Revised: Filed, December 18, 1986; Chapter Amended: December 1987. Revised: Filed, July 31, 1992; Extended: September 30, 1992; Extended: December 31, 1992. Certified: Ma…

Mental Illness Program Staff (Repealed) Notes Ala. Admin. Code r. 580-2-12-.01