ALERTs

Preferred Drug List (PDL) and Pharmacy Quarterly Update
Mar 7, 2024  -  Effective April 1, 2024, the Alabama Medicaid Agency (Medicaid) will: 1. Continue to monitor the stimulant shortage affecting ADHD medications. Should you need assistance, please contact Kepro at the number below for alternative prescribing and dispensing options.
Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease
Mar 7, 2024  -  Effective April 1, 2024, the Alabama Medicaid Agency (Medicaid) will implement hard edits on cumulative daily MME claims exceeding 120 MME/day. A phase-in period for claims exceeding 90 MME/day, but less than 120 MME/day, will also be implemented.
Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease
Mar 4, 2024  -  Effective April 1, 2024, the Alabama Medicaid Agency (Medicaid) will implement hard edits on cumulative daily MME claims exceeding 120 MME/day. A phase-in period for claims exceeding 90 MME/day, but less than 120 MME/day, will also be implemented.
Change to Behavioral Health Covered Services Procedure Codes
Feb 20, 2024  -  Effective January 1, 2024, Licensed Marriage and Family Therapists (LMFT) enrolled in Alabama Medicaid may provide a diagnosis for recipients under the age of 21 referred as a result of a valid, completed EPSDT screening from the recipient’s primary physician.

Recent ALERTs


Date 
Mar 7, 2024 Preferred Drug List (PDL) and Pharmacy Quarterly Update
Mar 7, 2024 Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease
Mar 4, 2024 Opioid Cumulative Daily Morphine Milligram Equivalents (MME) Limit – MME Decrease
Feb 20, 2024 Change to Behavioral Health Covered Services Procedure Codes
Feb 20, 2024 Notification of Request for Medical Records from Provider
Feb 20, 2024 In-Office General Anesthesia for Dental Services
Feb 13, 2024 Objective Developmental Testing
Feb 1, 2024 Fiscal Year (FY) 2025 (October 1, 2024-September 30, 2025) Patient-Centered Medical Home (PCMH) Attestation
Jan 24, 2024 Changes to Behavioral Health Service Location Criteria
Dec 28, 2023 New Coverage for Administration of Respiratory Syncytial Virus Vaccine 90678 and 90679
Dec 28, 2023 COVID-19 Vaccine Codes Added to VFC List
Dec 19, 2023 Provider Enrollment
Dec 5, 2023 AS Modifier Utilization for CRNP & PA Claims
Dec 1, 2023 Changes to Hepatitis C Prior Authorization (PA) Criteria
Dec 1, 2023 Preferred Drug List (PDL) and Pharmacy Quarterly Update
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Provider ALERTs older than 6 years have been archived and are available at www.media.alabama.gov