News

Section 1115 Demonstration waiver draft released for public comment

3/10/2014

A proposed blueprint of Alabama’s plan to transition Medicaid to a new healthcare delivery system is now available for public comment until Friday, April 4. Comments may be submitted by mail, email or during one of two public hearings in March. Emails may be directed to PublicComment@medicaid.alabama.gov while regular mail may be sent to the Agency’s Administrative Procedures Office. Public Hearings have been scheduled for March 13 at the Agency’s Central Office auditorium in Montgomery and on March 18 at the Birmingham Botanical Gardens. Both hearings will start at 10 a.m. After comments are received, the state will be eligible to formally submit its waiver application to the Centers for Medicare and Medicaid Services.  Click here for more information and a copy of the waiver draft.

“The state is seeking approval of a Section 1115 Demonstration waiver to implement a new care delivery model that will improve upon and ensure the long-term sustainability of Alabama’s Medicaid program,” Acting Medicaid Commissioner Stephanie Azar said. She added that the model will be based on the successes of three current programs administered by the Agency: Maternity Care, Patient 1st and the Patient Care Networks of Alabama (PCNs) and is expected to serve approximately 654,000 recipients.

1115 Demonstration waivers are used by states to research or test the cost and program effectiveness of innovative ideas that are otherwise not allowed under the state’s agreement with the federal government. In Alabama’s case, Medicaid hopes to test new strategies such as a delivery system through which risk bearing, provider-based regional care organizations are paid on a capitated basis, along with payment methodology changes that would move the state away from volume-based, fee-for-service reimbursement system to one that recognizes and rewards quality health outcomes.

“Our goal is to successfully implement a new healthcare delivery system by 2016,” said Azar. “We believe that approval and implementation of this waiver will enable the state to meet its overall goals of improving patient experience, improving health and reducing costs.”