HB361 Summary

• Amends Section 22-6-153 of the Code of Alabama 1975 to impose a limit on administrative costs paid by the Alabama Medicaid Agency to Regional Care Organizations (RCOs).

• Limits RCO administrative costs to not exceed the average administrative cost of the Alabama Medicaid agency over the last five fiscal years.

• Maintains existing provisions for RCO contracts, beneficiary enrollment and choice procedures, provider network requirements, and appeal/grievance procedures for patients and providers.

• Requires the Medicaid Agency to establish quality standards, implement quality assurance provisions, conduct financial audits at least every three years, and take other actions required by federal Medicaid regulations.

• Takes effect immediately upon passage and approval by the governor or upon otherwise becoming law.