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TO: All Providers
Medicaid providers with an interest in participating in the Integrated Provider System (IPS) program should be aware that a revised IPS timeline has been published to coincide with the Agency’s request for an October 1, 2017, go-live date for Regional Care Organizations (RCOs).
In December 2016, the Agency formally requested approval from the Centers for Medicare and Medicaid Services (CMS) to change the start date for the RCO program. An updated RCO implementation timeline is available by clicking here.
In addition to the updated timelines, interested providers and IPS applicants need to be aware of two other recent changes: 1) Withdrawal of three probationary Regional Care Organizations (PRCOs) from the RCO Program; and 2) A new Agency Rule (Alabama Medicaid Administrative Code Rule 560-X-62-.27) which allows an existing PRCO to enter an additional RCO region(s).
1) Alabama Care Plan (ACP) in Region B, Care Network of Alabama (CNA) in Region D, and Gulf Coast Regional Care Organization (GCRCO) in Region E made the decision in Fall 2016 not to pursue full certification as RCOs. As a result, providers may no longer partner with ACP, CNA, or GCRCO to submit IPS proposals to the Agency.
2) The Agency has created a process for existing PRCOs to enter an additional RCO region(s) by creating a new PRCO to serve the Medicaid beneficiaries in the additional region (see Rule 560-X-62-.27, referenced above). Providers may have the opportunity to submit IPS proposals to these new PRCOs in the near future. The Agency will notify providers of the contact information for submitting proposals to the new PRCOs when qualifying new PRCOs are prepared to accept IPS proposals.
Providers who previously submitted IPS proposals to ACP, CNA, or GCRCO may choose to submit proposals to one of the remaining PRCOs, or to a new PRCO established under the new rule and identified in writing by the Agency as eligible to receive IPS proposals.
Each PRCO will have its own deadline by which providers must submit an initial IPS proposal to the PRCO, and providers should contact the PRCO directly for more information. Click here to view the IPS contact information.
For more information on the IPS program, visit the following webpage: http://medicaid.alabama.gov/content/5.0_Managed_Care/5.1_RCOs/5.1.5_RCO_IPS.aspx.
Link to IPS Timeline 